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血液净化联合法舒地尔在老年心脏术后急性肾损伤中的治疗效果
引用本文:季艳梅,;张浩明,;方敏,;陈森,;郭家龙.血液净化联合法舒地尔在老年心脏术后急性肾损伤中的治疗效果[J].中国医师进修杂志,2014(14):1-3.
作者姓名:季艳梅  ;张浩明  ;方敏  ;陈森  ;郭家龙
作者单位:[1]湖北医药学院附属十堰市太和医院重症医学科,442000; [2]湖北医药学院附属十堰市太和医院心脏外科,442000
基金项目:湖北省自然科学基金(2011CDC051)
摘    要:目的 观察血液净化联合法舒地尔治疗老年心脏术后急性肾损伤的临床效果.方法 50例老年心脏术后急性肾损伤患者,按随机数字表法分为对照组和研究组,每组25例.均予常规药物治疗及血液净化,研究组在常规药物治疗及血液净化的同时给予法舒地尔注射液30 mg+0.9%氯化钠注射液50 ml静脉泵入,每12h1次,连用7d.观察治疗前后两组患者尿量、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿γ-谷氨酰转移酶(γ-GTP)、尿α1-微球蛋白(α1-MG)、血清肌酐(SCr)、血尿素氮(BUN)及肌酐清除率(CCr)的变化,并计算两组患者急性生理学和慢性健康评估(APACHE)Ⅱ评分.结果 两组治疗前各项指标比较差异均无统计学意义(P>0.05).研究组治疗后3,5,7d尿量明显多于同期对照组(38.72±2.68) ml/h比(31.68±2.52) ml/h、(47.24±3.73) ml/h比(40.24±2.52) ml/h、(63.80±2.50) ml/h比(56.60±3.30) ml/h],尿NAG、尿α1-MG、尿γ-GTP、SCr、BUN均明显低于同期对照组尿NAG:(25.05±5.44) U/L比(28.04±5.21) U/L、(24.06±3.43) U/L比(27.23±6.43) U/L、(22.08±3.25) U/L比(26.23±4.41) U/L;尿α1-MG:(24.05±3.65) mg/L比(26.74±6.74) mg/L、(22.98±3.58) mg/L比(25.57±3.58) mg/L、(20.95±3.78) mg/L比(25.48±3.45) mg/L;尿γ-GTP:(8.2±0.4) U/L比(10.8±3.8) U/L、(7.3±0.2) U/L比(10.5±2.5) U/L、(6.5±1.4) U/L比(9.7±2.6) U/L;SCr:(206.52±6.72)μmol/L比(255.16±6.75)μmol/L、(182.98±6.26)μmol/L比(252.23±9.53)μmol/L,(133.25±7.95)μmol/L比(170.75±7.94)μmol/L;BUN:(19.61±3.23) mmol/L比(20.25±3.25) mmol/L、(16.76±2.06) mmol/L比(18.32±4.84) mmol/L、(12.28±2.26) mmol/L比(14.27±4.54) mmol/L],CCr明显高于同期对照组(18.66±3.89) ml/min比(13.28±3.25) ml/min、(27.76±4.36) ml/min比(16.23±4.18) ml/min、(33.79±5.58) ml/min比(22.12?

关 键 词:心脏病  老年人  急性肾损伤  法舒地尔

Treatment effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury
Institution:Ji Yanmei, Zhang Haoming, Fang Min, Chen Sen, Guo Jialong( Department of Intensive Care Unit,Taihe Hospital Affiliated to Hubei Medical CoUege,Hubei Shiyan 442000, China)
Abstract:Objective To explore the clinical effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury.Methods Fifty elderly cardiac surgery patients with postoperative acute kidney injury were divided into control group and study group by random digit table method with 25 cases each.The 2 groups were treated with routine drug and blood purification,the study group was additionally given fasudil injection 30 mg + 0.9% sodium chloride injection 50 ml vein pumping,1 time/12 h,for 7 d.The urine volume,urine N-acetyl-β-D-glucosaminidase (NAG),urine γ-glutamyl transpeptidase (γ-GTP),urine α 1-microglobulin (α 1-MG),serum creatinine (SCr),blood urea nitrogen (BUN) and creatinine clearance rate (CCr) were observed,and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was computed.Results There were no statistical differences in the indexes before treatment between the 2 groups (P〉 0.05).The urine volume after treatment 3,5,7 d in study group was more than that in control group (38.72 ± 2.68) ml/h vs.(31.68 ± 2.52) ml/h,(47.24 ±3.73) ml/h vs.(40.24 ± 2.52) ml/h、(63.80 ± 2.50) ml/h vs.(56.60 ± 3.30) ml/h],urine NAG,urine α 1-MG,urine γ-GTP,SCr and BUN were lower than those in control group NAG:(25.05 ±5.44) U/L vs.(28.04 ± 5.21) U/L,(24.06 ± 3.43) U/L vs.(27.23 ± 6.43) U/L,(22.08 ± 3.25) U/L vs.(26.23 ± 4.41) U/L; α 1-MG:(24.05 ± 3.65) mg/L vs.(26.74 ± 6.74) mg/L,(22.98 ± 3.58) mg/L vs.(25.57 ± 3.58) mg/L,(20.95 ± 3.78) mg/L vs.(25.48 ± 3.45) mg/L; γ-GTP:(8.2 ± 0.4) U/L vs.(10.8 ± 3.8) U/L,(7.3 ± 0.2)U/L vs.(10.5 ± 2.5) U/L,(6.5 ± 1.4) U/L vs.(9.7 ± 2.6) U/L; SCr:(206.52 ± 6.72) μ mol/L vs.(255.16 ±6.75) μmol/L,(182.98 ±6.26) μmol/L vs.(252.23 ±9.53) μmol/L,(33.25 ±7.95) μmol/L vs.(170.75 ± 7.94) μ mol/L; BU N:(19.61 ± 3.23) mmol/
Keywords:Heart diseases  Aged  Acute kidney injury  Fasudil
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