CVVH联合尿毒清颗粒高位灌肠治疗急性肾功能衰竭疗效及对患者血清CysC NGAL表达的影响

目的探讨连续性静脉-静脉血液滤过技术联合尿毒清颗粒高位灌肠治疗急性肾功能衰竭的疗效及对患者血清胱抑素C、中性粒细胞明胶酶相关载脂蛋白表达的影响。方法将84例急性肾功能衰竭患者按照简单随机化法分为观察组与对照组,各42例。两组均给予常规治疗及连续性静脉-静脉血液滤过治疗,观察组在此基础上联合尿毒清颗粒高位灌肠治疗,观察2周。比较两组临床疗效,比较治疗前后两组血清胱抑素C、中性粒细胞明胶酶相关载脂蛋白、CD8⁺、CD4⁺、CD4⁺/CD8⁺、肿瘤坏死因子-α、白细胞介素-1、白细胞介素-6水平,比较两组15 d及28 d病死率。结果治疗后两组血清胱抑素C及中性粒细胞明胶酶相关载脂蛋白水平均较治疗前显著下降(P<0.01),观察组较对照组下降更显著(P<0.01),两组CD8⁺水平均显著低于治疗前(P<0.01),CD4⁺、CD4⁺/CD8⁺水平均显著高于治疗前(P<0.05或0.01),观察组较对照组变化更显著(P<0.01),两组血清肿瘤坏死因子-α、白细胞介素-1、白细胞介素-6水平均较治疗前显著下降(P<0.01),观察组较对照组下降更显著(P<0.01)。观察组总有效率显著高于对照组(P<0.05),15 d及28 d病死率均显著低于对照组(P<0.05)。结论连续性静脉-静脉血液滤过技术联合尿毒清颗粒高位灌肠治疗可下调急性肾功能衰竭患者血清胱抑素C、中性粒细胞明胶酶相关载脂蛋白水平,减轻炎症反应,增强机体免疫功能,提高治疗效果,降低病死率。

The clinical effect of continuous vein-vein hemofiltration combined with high enema of Niaoduqing granule in the treatment of acute renal failure and its effect on the expression of serum CysC and NGAL in patients

Objective To investigate the effect of continuous vein-vein hemofiltration(CVVH)combined with high enema of Niaoduqing granules in the treatment of acute renal failure(ARF)and its influence on the expression of serum Cystatin C(CysC)and neutrophil gelatinase-associated apolipoprotein(NGAL).Methods According to the simple randomization method,84 patients with ARF were divided into observation group and control group,with 42 cases in each group.Both groups were given conventional treatment and CVVH treatment.On this basis,the observation group was treated with high-position enema treatment with Niaoduqing granules and observed for 2 weeks.To compare the clinical efficacy,the serum CysC,NGAL,CD8⁺,CD4⁺,CD4⁺/CD8⁺,tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)level before and after treatment,and compare the 15-day and 28-day mortality of the two groups.Results After treatment,serum CysC and NGAL levels in the two groups were significantly lower than before treatment(P<0.01),and the observation group was significantly lower than that in the control group(P<0.01).The CD8⁺levels in the two groups were significantly lower than before treatment(P<0.01),CD4⁺,CD4⁺/CD8⁺levels were significantly higher than before treatment(P<0.05 or 0.01),and the changes in the observation group were more significant than those in the control group(P<0.01).The levels of serum TNF-α,IL-1,and IL-6 in the two groups were significantly lower than before treatment(P<0.01),and the decrease in the observation group was more significant than that in the control group(P<0.01).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05),and the 15-day and 28-day mortality were significantly lower than those of the control group(P<0.05).Conclusions CVVH combined with high enema of Niaoduqing granule can down-regulate serum CysC and NGAL levels in patients with acute renal failure,reduce inflammation,enhance immune function,improve therapeutic effects,and reduce mortality.