前列地尔联合肾脏替代疗法治疗脓毒症合并急性肾损伤患者的临床研究  

Clinical Study on the Effects of Alprostadil Combined with Continuous Renal Replacement Therapy in Patients with Sepsis and Acute Kidney Injury

作　　者：龚建[1] GONG jian(Department of Critical Care Medicine,Zhengzhou People's Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]郑州人民医院重症医学科,河南郑州450000

出　　处：《临床研究》2025年第4期72-75,共4页Clinical Research

摘　　要：目的探讨前列地尔联合连续性肾脏替代疗法(CRRT)治疗脓毒症并发急性肾损伤患者的效果,并分析其血清微小核糖核酸(miR)-155及miR-233表达水平的变化情况及潜在意义。方法选取2021年1月至2023年1月郑州人民医院收治的82例脓毒症合并急性肾损伤患者进行回顾性分析,按照入院后治疗方式不同分为对照组和观察组,各41例。对照组进行CRRT治疗,观察组进行前列地尔联合CRRT治疗,比较两组患者治疗前后炎症因子指标、肾功能指标水平、miR-155、miR-233相对表达量及皮疹、胃肠道反应、头疼发生情况。结果与治疗前比较,两组患者治疗后降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平下降,且相比于对照组,观察组更低,差异有统计学意义(P<0.05)。两组患者治疗后血肌酐(Scr)、24 h尿蛋白定量、尿素氮(BUN)水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后miR-155、miR-233相对表达量低于治疗前,且相比于对照组,观察组更低,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论前列地尔联合CRRT可以降低脓毒症合并急性肾损伤患者体内炎症因子水平,改善患者肾功能,调节体内miR-155、miR-233表达,安全性良好。Objective To explore the effects of alprostadil combined with continuous renal replacement therapy(CRRT)in patients with sepsis complicated by acute kidney injury,and to analyze the changes and potential significance of serum microRNA(miR)-155 and miR-233 expression levels.Methods A retrospective analysis was conducted on 82 patients with sepsis complicated by acute kidney injury admitted to Zhengzhou People's Hospital from January 2021 to January 2023.According to the different treatment methods after admission,the patients were divided into a control group and an observation group,with 41 cases in each group.The control group received CRRT,while the observation group received alprostadil combined with CRRT.The levels of inflammatory factors,kidney function indicators,relative expression of miR-155 and miR-233,as well as the incidence of rash,gastrointestinal reactions,and headaches were compared between the two groups before and after treatment.Results Compared to before treatment,the levels of procalcitonin(PCT),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)decreased after treatment in both groups,and the observation group had lower levels compared to the control group,with statistically significant differences(P<0.05).After treatment,serum creatinine(Scr),24-hour urine protein quantification,and blood urea nitrogen(BUN)levels were lower than those before treatment in both groups,and were also lower in the observation group compared to the control group,with statistically significant differences(P<0.05).The relative expression levels of miR-155 and miR-233 decreased after treatment in both groups,and the observation group had lower levels compared to the control group,showing statistical significance(P<0.05).There were no significant differences in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Alprostadil combined with CRRT can reduce the levels of inflammatory factors in patients with sepsis complicated by acute kidney injury,improve kidney function,and regulate the

关 键 词：前列地尔 肾脏替代疗法 脓毒症 急性肾损伤 微小核糖核酸-155 微小核糖核酸-233 

分 类 号：R631[医药卫生—外科学]