连续性肾脏替代治疗联合中药灌肠对急性肾损伤患者尿KIM-1、NGAL水平的影响

目的:探讨连续性肾脏替代治疗(CRRT)联合中药灌肠对重症急性肾损伤患者尿肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平和预后的影响。方法:回顾性分析89例重症急性肾损伤患者临床资料,依据不同治疗方式分为对照组43例和研究组46例,对照组采用CRRT治疗,研究组采用CRRT联合中药灌肠治疗。比较两组尿量恢复时间、重症医学科(ICU)住院时间、治疗前后肾功能、尿KIM-1、NGAL水平,序贯器官衰竭估计评分(SOFA)、急性生理与慢性健康评分表(APACHEⅡ)评分和预后情况。结果:研究组尿量恢复时间、ICU住院时间均少于对照组(P<0.05)。治疗前,两组肾功能、尿KIM-1、NGAL水平,SOFA、APACHEⅡ评分比较,差异无统计学意义(P>0.05); 治疗后,两组肾功能指标、尿KIM-1、NGAL水平,SOFA、APACHEⅡ评分均较治疗前下降,研究组低于对照组,差异有统计学意义(P<0.05)。研究组死亡率较对照组低(P<0.05)。结论:CRRT联合中药灌肠能够促进重症急性肾损伤患者肾功能的恢复,降低尿KIM-1、NGAL水平,改善预后。

Effect of CRRT combined with clyster with Chinese herbs on urinary KIM-1,NGAL level and prognosis in patients with severe acute renal injury

Objective:To investigate the effect of continuous renal replacement therapy(CRRT)combined with traditional Chinese medicine enema on the level and prognosis of urinary renal injury molecule-1(KIM-1),neutrophil gelatinase related lipid delivery protein(NGAL)in patients with severe acute renal injury.Methods:The clinical data of 89 patients with severe acute renal injury were analyzed retrospectively.According to different treatment methods,they were divided into control group(n=43)and study group(n=46).The control group was treated with CRRT,and the study group was treated with CRRT and traditional Chinese medicine.The recovery time of urine volume,hospitalization time of ICU,renal function,urinary KIM-1,NGAL level,sequential organ failure assessment score(sofa),acute physiology and chronic health score(APACHE Ⅱ)and prognosis were compared between the two groups.Results:The recovery time of urine volume and ICU hospitalization time in the study group were shorter than those in the control group(P<0.05).Before treatment,there was no significant difference in renal function,urinary KIM-1,NGAL level,sofa,APACHE II scores between the two groups(P>0.05);after treatment,the renal function index,urinary KIM-1,NGAL level,sofa,APACHE II scores of the two groups were lower than before treatment,the difference was statistically significant(P<0.05).The mortality rate of the study group was lower than that of the control group(P<0.05).Conclusion:CRRT combined with traditional Chinese medicine enema can promote the recovery of renal function in patients with severe acute renal injury,reduce the level of urinary KIM-1 and NGAL,and improve the prognosis.