摘要
目的探讨参芪扶正注射液(参芪液)对体外循环(CPB)心脏手术后肾功能的影响。方法选取40例CPB心脏手术患者,随机分为参芪液组和对照组,每组20例。参芪液组于麻醉前静脉滴注参芪液250ml,CPB之前以参芪液125 ml加入预充液中,术后3 d每日静脉滴注参芪液250 ml;对照组均予等量平衡液。于麻醉前及术后即刻和1、3、5 d留取中心静脉血及尿液,检测各时间点血肌酐(Cr)、尿Cr、尿微量白蛋白(m-Alb)、尿β_2-微球蛋白(β_2-MG)、尿-N-乙酰氨基葡萄糖苷酶(NAG),并计算内生肌酐清除率(CCr)。结果两组患者术后各时间点尿m-Alb、β_2-MG、NAG均明显升高(P均<0.05),参芪液组升高程度明显低于对照组(P均<0.05);对照组CCr在术后1～3 d明显下降(P均<0.05),参芪液组术后各时间点CCr下降不明显(P均>0.05)。结论CPB可以导致肾功能损害,围手术期应用参芪液对肾功能有一定保护作用。
Objective To study the effect of Shenqi Fuzheng injection （SQFZI, 参芪扶正注射液） on renal function in patients after cardiac surgery and cardiopulmonary bypass （CPB）. Methods Forty patients ready for receiving CPB and cardiac surgery were randomly assigned to two groups, 20 being in each group. Patients in the SQFZI group were administered of 250 ml SQFZI intravenously before anesthesia, 125 ml SQFZI before CPB in CPB mechanical equipment, and 250 ml SQFZI once a day after operation for 3 days. Equal volume balanced solution was received in control group. Creatinine （Cr） in blood and Cr, microalbumin （m-Alb）, β2-microglobulin （β2-MG） and N-acetylglucosaminidase （NAG） in urine were measured and endogeneous creatinine clearance （CCr） was calculated in 40 patients at the time points of before anesthesia, at the end of operation, and 1, 3 and 5 days after operation. Results Urinary levels of m-Alb, β2-MG and NAG were increased significantly after CPB in both groups at different time points at the end of and after the operation （all P〈0.05）, but the increment were significantly lower in the SQFZI group than those in the control group（all P〈0. 05）. Furthermore, CCr was decreased markedly 1 - 3 days after CPB in the control group （all P〈0.05）, while the decrease of CCr in the SQFZI group was not significant respectively at the various corresponding time points （all P 〉 0.05）. Conclusion CPB has a deteriorating effect on renal function, and the application of SQFZI in peri-operational period has a protective effect on renal function in patients who undergo CPB.
出处
《中国中西医结合急救杂志》
CAS
2008年第4期209-211,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
山东省青岛市科技发展计划资助项目(05-1-NS-74)
关键词
参芪扶正注射液
体外循环
肾功能
Shenqi Fuzheng injection
cardiopulmonary bypass
renal function
