摘要
目的 分析前列地尔注射液治疗心脏术后急性肾损伤的临床疗效.方法 根据计算机完全随机化原则,将63例心脏术后急性肾损伤患者分为对照组31例和研究组32例进行前瞻性研究,均予常规治疗,研究组在常规治疗的同时给予前列地尔注射液10μg＋生理盐水10 ml缓慢静注,每12小时1次,连用7 d.研究组中1例11岁患者（体重24 kg）使用前列地尔注射液时剂量减半.对照治疗期间,对照组1例、研究组2例患者因需透析治疗被剔除.观察对照治疗前后两组患者尿量、尿N-乙酰-β-D-氨基葡萄糖苷酶、尿α1-微球蛋白、尿β2-微球蛋白、血清肌酐、血尿素氮的变化,并计算两组患者重症监护病房（ICU）停留时间、对照治疗结束后透析治疗率.研究组患者使用前列地尔注射液期间观察药物不良反应.结果 与对照组相比,研究组治疗后尿量明显多[（65.9±3.1）ml/h比（58.8±4.5）ml/h,P＜0.05],尿N-乙酰-β-D-氨基葡萄糖苷酶、尿α1-微球蛋白、尿β2-微球蛋白、血清肌酐、血尿素氮均明显低（均P＜0.05）.研究组ICU停留时间短于对照组[（12±5）d比（17±5）d,P＜0.05],但两组对照治疗结束后透析治疗率无明显差异（3.3%比6.7%,P＞0.05）.研究组患者使用前列地尔注射液期间无严重不良反应.结论 在常规治疗的基础上加用前列地尔注射液治疗对心脏术后急性肾损伤患者肾功能的恢复具有一定促进作用.
Objective To explore the clinical effects of alprostadil injection on acute kidney injury （AKI） after cardiac surgical procedures by a prospective randomized controlled trial. Methods A total of 63 AKI-patients after cardiac surgical procedures were randomly divided into the control group （n=31） and the study group （n=32）. All patients received routine therapy while patients in the study group were additionally given alprostadil injection （10 μg i. v. once every 12 hours） for 7 days. A 11-year-old patient weighing 29 kg was given half of the conventional dose. During the period of control treatment （7 days）, 1patient in the control group and 2 patients in the study group were excluded because of hemodialysis or peritoneal dialysis. Urine volume, urine β-N-acetyglocosamidase, urine α1-microglobulin, urine β2-microglobulin, serum creatinine and blood urea nitrogen were measured before and after the control treatment. And the ICU stay duration and the percentage of dialysis after the control treatment were calculated. Adverse reactions of alprostadil injection were observed simultaneously in the study group.Results After the treatment, urine volume in the study group was obviously more than that in the control group [（65.9±3.1） ml/h vs （58.8±4.5） ml/h, P〈0.05] while urine β-N-acetyglocosamidase, urine α1 -microglobulin, urine β2-microglobulin, serum creatinine and blood urea nitrogen in the study group were obviously lower than those in the control group （all P〈0.05）. The ICU stay duration in the study group was obviously less than that in the control group [（12±5）d vs （17±5） d, P 〈0.05]. But there was no significant difference in the percentage of dialysis after the control treatment between two groups （3. 3% vs 6. 7%, P 〉 0. 05）. And no serious adverse reaction was reported in the study group. Conclusion On the basis of routine therapy, alprostadil injection may promote the recovery of renal function in AKI-patients after cardiac surgical procedures.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第32期2266-2269,共4页
National Medical Journal of China
关键词
前列地尔
心脏外科手术
肾功能衰竭
急性
Alprostadil Cardiac surgical procedures Kidney failure,acute
