不同滤过剂量的连续性肾脏替代治疗在重症合并急性肾损伤患者治疗中的效果  

Effect of Continuous Renal Replacement Therapy with Different Filtration Doses in the Treatment of Severe Patients with Acute Kidney Injury

作　　者：黄杨斌 邱顺年 HUANG Yangbin;QIU Shunnian(Department of Critical Care Medicine,Jiangle General Hospital,Jiangle,Fujian,353300,China)

机构地区：[1]将乐县总医院重症医学科,福建将乐353300

出　　处：《中外医疗》2025年第8期35-39,共5页China & Foreign Medical Treatment

摘　　要：目的探究不同滤过剂量的连续性肾替代治疗重症合并急性肾损伤的临床疗效。方法方便选取2021年1月—2024年2月将乐县总医院收治的133例重症合并急性肾损伤患者为研究对象,按照不同滤过剂量分为两组,对照组(65例)滤过剂量为25 mL/(kg·h),研究组(68例)滤过剂量为70 mL/(kg·h)。比较两组患者肾功能指标、血流动力学指标、炎症因子、免疫功能指标。结果治疗后,研究组血肌酐(88.54±10.11)μmol/L、血尿素氮(7.01±0.35)mmol/L均低于对照组的(100.65±15.68)μmol/L、(8.65±0.45)mmol/L,24 h尿量(1540.24±56.64)mL大于对照组的(1268.54±40.81)mL,差异均有统计学意义(t=5.317,23.520,31.615;P均<0.05)。治疗后,研究组心率、平均动脉压均低于对照组,心排血量大于对照组,差异均有统计学意义(P均<0.05)。治疗后,研究组C反应蛋白、白细胞介素-6、降钙素原、肿瘤坏死因子水平均低于对照组,差异均有统计学意义(P均<0.05)。治疗后,研究组CD3+、CD4+及CD4+/CD8+均高于对照组,CD8+低于对照组,差异均有统计学意义(P均<0.05)。结论与低滤过剂量的肾替代治疗相比,重症合并急性肾损伤患者采取高滤过剂量的连续性肾替代治疗可促进改善肾功能,对血流动力学影响小,可降低炎症因子,增强免疫功能。Objective To explore the clinical efficacy of continuous renal replacement therapy with different filtration doses in the treatment of severe patients with acute kidney injury.Methods A total of 133 patients with severe and acute kidney injury admitted to Jiangle General Hospital from January 2021 to February 2024 were conveniently selected as the study subjects and divided into two groups according to different filtration dosages:control group(65 cases)with a filtration dose of 25 mL/(kg·h),and study group(68 cases)with a filtration dose of 70 mL/(kg·h).Renal function indexes,hemodynamic indexes,inflammatory factors and immune function indexes were compared between the two groups.Results After treatment,serum creatinine(88.54±10.11)μmol/L and blood urea nitrogen(7.01±0.35)mmol/L in the study group were lower than those in the control group(100.65±15.68)μmol/L and(8.65±0.45)mmol/L,the urine volume at 24 h(1540.24±56.64)mL was higher than that of the control group(1268.54±40.81)mL,and the differences were statistically significant(t=5.317,23.520,31.615;all P<0.05).After treatment,the heart rate and mean artery pressure of the study group were lower than that of the control group,and the cardiac output was higher than that of the control group,the differences were statistically significant(all P<0.05).After treatment,the levels of Creactive protein,interleukin-6,procalcitonin and tumor necrosis factor in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,CD3+,CD4+and CD4+/CD8+in the study group were higher than those in the control group,and CD8+was lower than that in the control group,and the differences were statistically significant(all P<0.05).Conclusion Compared with low-dose renal replacement therapy,high-dose continuous renal replacement therapy can improve renal function,have little effect on hemodynamics,reduce inflammatory factors and enhance immune function in severe patients with acute renal injury.

关 键 词：急性肾损伤 连续性肾脏替代治疗 滤过剂量 肾功能 炎症因子 免疫功能 血流动力学 

分 类 号：R692[医药卫生—泌尿科学]