前列地尔治疗急性肾损伤疗效观察

目的 探讨前列地尔(PGE1)治疗急性肾损伤(Acute Kidney Injury,AKI)的临床疗效.方法 收集海南省人民医院肾病风湿科自2010年1月～2012年1月住院治疗的急性肾损伤患者56例,随机分为治疗组(28例)和对照组(28例).两组常规用药相同,治疗组加用PGE1静脉滴注,每天1次,连续2周.比较两组患者治疗前后尿NAG酶、尿渗透压、血肌酐、尿素氮、尿β2微球蛋白以及肾衰指数、肾小球滤过率及进入透析人数的变化.结果 治疗组治疗后,尿NAG酶、血肌酐、尿素氮、尿β2微球蛋白以及肾衰指数明显低于对照组,尿渗透压、肾小球滤过率明显高于对照组(P＜0.05).治疗组进入透析的人数(6人)低于对照组(13人)(x2=3.9,P＜ 0.05).结论 PGE1可促进AKI缓解,增强疗效.

Effect of alprostadil on patients with acute kidney ynjury

Objective To observe the effect of alprostadil（PGE1） on patients with acute kidney injury（AKI）.Methods The 56 patients,definitely diagnosed as AKI in Department of Nephrology and Rheumatology of Hainan Provincial People＇s Hospital during Jan 2010 to Jun 2012,were randomly divided into treatment group（28 patients） and control group（28 patients）.All the patients in two groups were received the basic therapy,PGE1 at dose of 10μg ivgtt qd was added to those in the treatment group for two weeks.The urine osmotic pressure and levels of urinary NAG enzyme,serum creatinine,blood urea nitrogen,urine beta 2 microglobulin and renal failure index and glomerular filtration rate in the two groups were determined and compared before and after treatment.Results In the treatment group before and treatmernt the levels of Bun were 34.56±4.61mmol/L,10.33±2.11mmol/L,Cr were 284.17±10.86μmol/L,125.85±29.01μmol/L,Urinary NAG60 were 4±20.4U/L,24.09±5.86U/L,Urine osmotic pressure were 495.85±32.42mmol/L,795±103.41mmol/L,Urine β2 microglobulin1 were 26±0.52mg/L、0.54±0.14mg/L,Renal failure index1.9±0.82,0.8±0.31,Glomerular filtration rates were 82±7.87ml/min,98±10.60ml/min,number of dialysis was 6）.While that of the control group the levels of Bun were 32.78±5.81mmol/L,29.56±5.77mmol/L,Cr were 277.56±12.50umol/L,175.78±37.32umol/L,Urinary NAG64 were 5±18.3U/L,36.11±9.97U/L,Urine osmotic pressure were 513.57±65.98mmol/L,584.57±105.25mmol/L,Urine β2 microglobulin1 were 15±0.59mg/L,0.75±0.16mg/L,Renal failure index were 1.61±0.52,1.1±0.49,Glomerular filtration rates were 76±12.23ml/min,80.29±9.11ml/min,number of dialysis was 13）.The levels of urinary NAG enzyme,serum creatinine,blood urea nitrogen,urine beta 2 microglobulin and renal failure index in the treatment group after treatment,were all significantly lower as compared to the control group.While the urine osmotic pressure,glomerular filtration rate were obviously higher in treatment group than those of the control group（P0.05）.The number required for dialysis treatment in treatment group was less than that in control group（X2 =3.9,P﹤0.05）.Conclusion PGE1 can relieve AKI and enhance the therapeutic effect.