乌司他丁联合间歇性血液透析对脓毒症急性肾损伤患者尿IGFBP-7及HMGB1水平的影响被引量：10

Effect of urinastatin and intermittent hemodialysis on the levels of urinary IGFBP-7 and HMGB1 in patients withsepsis-induced acute kidney injury

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摘要目的:探讨乌司他丁联合间歇性血液透析(IHD)对脓毒症急性肾损伤(AKI)患者尿胰岛素样生长因子结合蛋白7(IGFBP-7)及高迁移率族蛋白1(HMGB1)水平的影响。方法:选择脓毒症AKI患者128例,随机分为对照组和观察组,每组64例。对照组采用IHD治疗,观察组采用乌司他丁联合IHD治疗,比较治疗前、后2组患者的急性生理学及慢性健康评估(APACHE II)评分、多器官功能障碍评分系统(Marshall)评分,血清尿氮素(BUN)、血肌酐(SCr)、胱抑素(Cys C)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平以及尿IGFBP-7和HMGB1水平的变化。结果:治疗后2组APACHE II、Marshall评分、血BUN、SCr、Cys C、hs-CRP、TNF-α、IL-6水平、尿IGFBP-7、HMGB1水平均显著降低,且观察组显著低于对照组(均P <0. 05)。结论:乌司他丁联合IHD对脓毒症AKI患者具有更好的疗效,可保护肾功能,降低炎性因子水平,并具有下调尿IGFBP-7及HMGB1分泌的作用。 Objective:To investigate the effects of ulinastatin and intermittent hemodialysis(IHD)on urine insulin-like growth factor binding protein 7(IGFBP-7)and high mobility group proteins(HMGB1)levels in patients with sepsis-induced acute kidney injury(AKI).Methods:128 patients with sepsis-induced AKI were randomly divided into two groups with 64 patients in each group.The control group received IHD treatment and the observation group received ulinastatin combined with IHD.APACHE II and Marshall scores,serum BUN,SCr,CysC,hs-CRP,TNF-αand IL-6 levels,and urinary IGFBP-7 and HMGB1 levels before and after treatment were compared between the two groups.Results:After treatment,the APACHE II and Marshall scores decreased significantly in both groups,the serum levels of BUN,SCr and CysC,and hs-CRP,TNF-αand IL-6,the levels of urinary IGFBP-7 and HMGB1 were lower in both groups,and those were significantly lower in the observation group than in the control group(all P<0.05).Conclusion:Ulinastatin combined with IHD has satisfactory curative effect on AKI induced by sepsis,protects renal function,reduces the level of inflammatory factors,and has the effect of down-regulating urinary IGFBP-7 and HMGB1 secretion.

作者郑娜程延娜杨海燕 ZHENG Na;CHENG Yan-na;YANG Hai-yan(Yan'an University Hospital,Yan'an 716000,China)

机构地区延安大学附属医院

出处《内科急危重症杂志》 2020年第2期134-137,共4页 Journal of Critical Care In Internal Medicine

关键词乌司他丁脓毒症急性肾损伤胰岛素样生长因子结合蛋白7 高迁移率族蛋白1 Urinastatin Sepsis Acute kidney injury Insulin-like growth factor binding protein 7 High mobility group proteins

分类号 R459.7 [医药卫生—急诊医学] R692 [医药卫生—泌尿科学]

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