新活素对体外循环心内直视手术后肾功能损害患者心、肾功能的影响

目的观察新活素对体外循环心内直视手术后肾功能损害患者心、肾功能的影响。方法32例体外循环术后肾功能损害患者随机分为2组，治疗组在常规治疗的基础上予新活素（重组人脑利钠肽）静脉注射治疗；对照组仅予常规强心、利尿。观察治疗前后尿量、血肌酐（SCr）、估算的肾小球滤过率（eGFR）、左心室射血分数（LVEF）、中心静脉压（CVP）、收缩压（SBP）的变化。结果对照组尿量、CVP、SCr、eGFR较治疗前有改善，其中4例患者行CRRT治疗，死亡1例（6．25％）。与对照组相比，治疗组治疗后48h的SCr、eGFR、CVP均显著优于对照组（P〈0．01），LVEF改善优于对照组（P〈0．05）。治疗组肾功能恢复14例（87．5％），2例肾功能无明显改善改行CRRT治疗。结论体外循环心内直视手术后肾功能损害患者加用新活素能有效地改善心、肾功能。

Effects of recombinant human brain natrinretic peptide on postoperative heart and renal function in patients with renal insufficiency undergoing cardiac surgery with cardiopulmonary bypass

Objective To investigate the effects of recombinant human brain natriuretic peptide （rhBNP） on postoperative heart and renal function in patients with renal insufficiency undergoing cardiac surgery with car-diopulmonary bypass. Methods 32 patients with renal insufficiency undergoing coronary artery bypass were en- rolled in this study. 16 patients in control group were intravenously given conventional therapy and 16 patients in rhBNP group were intravenously given rhBNP. Urine volume, serum creatinine （SCr）, estimated glomerular filtra- tion rate（eGFR）, left ventricular ejection fraction（LVEF） and central venous pressure（CVP） were measured be- fore and after treatment. Results Urine volume, CVP, SCr, eGFR in control group had improved. Compared with control group, the 48 h levels of SCr, eGFR, LVEF and CVP changed significantly （P〈0.01）, LVEF changed （P〈0.05）. 14 （87.5%） had restored renal function and 2 treated invalidly were changed to continuous renal re- placement therapy （CRRT）. Conclusion rhBNP may effectively improve the heart and renal function of patients with renal insufficiency undergoing cardiac surgery.