乌司他丁对瓣膜置换术患者肾脏的保护作用

目的:探讨乌司他丁对心脏瓣膜置换术患者肾脏的保护作用。方法:53例心脏瓣膜置换术患者随机分为两组,试验组(U组,n=30),对照组(C组,n=23)。试验组术中予乌司他丁2万u/kg静脉注射,对照组给生理盐水。于术前30分钟,主动脉阻断前5分钟,主动脉开放后5分钟,手术结束时,以及术后第1、3、5天查尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿肌酐(Cr)求两者比值NAG/Cr,血尿素氮(BUN)、Cr,并记录尿流率及术后速尿使用总量。结果:主动脉开放后5分钟、手术结束时、术后第1天试验组尿NAG/Cr值低于对照组(p<0·05);尿流率高于对照组(P<0·05);试验组术后速尿使用总量少于对照组(P<0·05);两组间血清BUN、Cr无统计学差异。结论:心脏瓣膜置换术中使用乌司他丁有利于肾脏保护。

The Protective Effect of Ulinastatin on Kidney for Patients with Prosthetic Valve Replacement during Perioperative Period

Objective:To investigate the protective effect of ulinastatin(UTI)on kidney in patients with prosthetic valve replacement during perioperative period.Methods:Fifty-three patients undergoing prosthetic valve replacement were divided into two groups randomly:UTI group(group U,n=30)and control group(group C,n=23).In group U,each patient got UTI 20,000 u/kilogram body weight intravenously during the operation. Urinary and blood samples were taken from the patient 30 min before operation(T1),5 min before aorta cross-clamping(T2),5 min after reperfusion(T3),at the end of the operation(T4),and 1,3 and 5days(T5,T6,T7)after operation,respectively.NAG,urinary creatine(Cr),NAG/Cr,urinary flow rate,BUN,blood creatine were tested.The total dose of postoperative furosemide was recorded,too.Results:NAG/Cr of UTI group was significantly lower than that of the control group at T3,T4,T5;The total dose of furosemide was smaller than the control group,too.There was no significant difference in the examination of BUN and the blood creatine level between the two group.Conclusion:There was some protective effect of UTI on kidnay in patients with prosthetic valve replacement.