前列地尔辅助连续性肾脏替代疗法治疗脓毒症伴急性肾损伤的效果  

Effect of Alprostadil Assisted Continuous Renal Replacement Therapy in the Treatment of Sepsis with Acute Kidney Injury

作　　者：张瑞霞[1] 左来孟[1] 宋琼[1] ZHANG Ruixia;ZUO Laimeng;SONG Qiong(Department of Nephrology,Rheumatology and Immunology,the First People’s Hospital of Xinxiang,Xinxiang 453000,China)

机构地区：[1]新乡市第一人民医院肾病风湿免疫科,河南新乡453000

出　　处：《河南医学研究》2025年第3期507-511,共5页Henan Medical Research

摘　　要：目的 探讨前列地尔辅助连续性肾脏替代疗法(CRRT)治疗脓毒症伴急性肾损伤(AKI)的效果及安全性。方法 纳入新乡市第一人民医院2020年2月至2023年2月88例脓毒症伴AKI患者,采取随机数字表法分为观察组(44例)与对照组(44例)。对照组、观察组分别接受CRRT单独及联合前列地尔治疗,两组均治疗10 d。记录两组临床疗效;治疗前后,检测两组肾血流参数、肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、血尿酸(UA)]、肾损伤分子-1(Kim-1)、微小核糖核酸(miR)-155、miR-233水平;记录两组不良反应发生情况。结果 观察组总有效率更高(P<0.05)。治疗后,观察组肾血流参数改善程度优于对照组(P<0.05)。治疗后,观察组SCr、BUN、UA水平低于对照组(P<0.05)。治疗后,观察组Kim-1、miR-155、miR-233水平低于对照组(P<0.05)。观察组与对照组不良反应总发生率比较(11.36%比4.55%),差异无统计学意义(P>0.05)。结论 前列地尔辅助CRRT治疗脓毒症伴AKI具有显著效果,可改善患者肾脏功能,减轻肾脏损伤及炎症反应,且安全性较高。Objective To investigate the efficacy and safety of alprostadil assisted continuous renal replacement therapy(CRRT)in the treatment of sepsis with acute kidney injury(AKI).Methods A total of 88 sepsis patients with AKI admitted to the First People’s Hospital of Xinxiang from February 2020 to February 2023 were divided into observation group(44 cases)and control group(44 cases)by random number table method.Control group and observation group were given CRRT alone and combined with alprostadil.Both groups were treated for 10 days.The clinical effects of the two groups were recorded.Before and after treatment,renal blood flow parameters,renal function indexes[serum creatinine(SCr),blood urea nitrogen(BUN),blood uric acid(UA)],kidney injury molecule 1(Kim-1),microRNA(miR)-155,miR-233 in both groups were detected.The occurrence of adverse reactions in the two groups was recorded.Results The total effective rate of observation group was higher(P<0.05).After treatment,compared with the control group,renal blood flow parameters improved better in observation group(P<0.05).After treatment,compared with the control group,the levels of SCr,BUN and UA in observation group were lower(P<0.05).After treatment,compared with the control group,the levels of Kim-1,miR-155 and miR-233 in the observation group were lower(P<0.05).The total incidence of adverse reactions was compared between the observation group and the control group(11.36%vs 4.55%)(P>0.05).Conclusion Alprostadil assisted CRRT in the treatment of sepsis with AKI has a significant effect,can improve the kidney function of patients,reduce kidney damage,and has a high safety.

关 键 词：脓毒症 急性肾损伤 连续性肾脏替代疗法 前列地尔 

分 类 号：R692[医药卫生—泌尿科学]