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30min,主动脉阻断前5min,主动脉开放后5min,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,测血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5min、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差异无统计学意义。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 kidneys of patients undergoing prosthetic valve replacement

Objective To investigate the protective effect of ulinastatin (UTI) on kidneys of patients subjected pros- thetic valve replacement during perio- operative period.Methods Fifty - three patients undergoing prosthetic valve replacement were randomly divided into two groups: UTI group (n=23) and control group (n=30). In UTI group,each patient get UTI 20,000 U/ kg body weight intravenously during the operation. Urinary and blood sample was takenfrom the patient at the time of 30 min before operation (T1), 5 min before aorta cross- clamping (T2), 5 min after reperfu-sion (T3), at the end of the operation (T4),1, 3 and 5days (T5, T6, T7) after operation respectively. NAG, urinary creatine(Cr), NAG/Cr, urinary flow rate, BUN, blood creatine were detected. The total dose of postoperative furosemide wasrecorded too. Results Compared with control group, NAG/ Cr and the total dose of furosemide in UTI group significant-ly decreased at T3,T4,T5. There was no significant difference of BUN, blood creatine level between two groups. Conclu-sion There are some protective effects of UTI on renal function of patients with prosthetic valve replacement.