CAJ | 학술논문

目的：观察前列地尔强化治疗对老年患者心脏术后急性肾损伤的保护作用。方法53例老年心脏术后急性肾损害患者，经患者知情同意，并医院伦理委员会批准，将患者分为研究组（27例）和对照组（26例）。2组均予常规药物治疗，研究组在常规治疗同时给予前列地尔注射液10μg＋生理盐水10 ml缓慢静脉注射，每12 h 1次，连用7 d。观察治疗前后2组患者尿量、尿N-乙酰-β-D-氨基葡萄糖苷酶、尿γ-谷氨酰转肽酶、尿α1-微球蛋白（α1-MG）、血清肌酐、血尿素氮的变化，并计算2组患者重症监护病房（ ICU）停留时间、治疗结束后透析治疗率，观察使用前列地尔注射液期间的不良反应。结果与对照组相比，研究组治疗后尿量明显增多[（63．8±2．5）ml／h比（56．6±3．3）ml／h]，差异有统计学意义（P＜0．05），尿N-乙酰-β-D-氨基葡萄糖苷酶、尿γ-谷氨酰转肽酶、尿α1-微球蛋白（1-MG）、血清肌酐、血尿素氮均明显降低，差异有统计学意义（P＜0．05）；研究组ICU停留时间短于对照组[（11±4）d比（15±3）d]，差异有统计学意义（P＜0．05），但2组治疗结束后透析治疗率（3.4％比4．5％）差异无统计学意义（P＞0．05）；研究组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，对老年心脏术后急性肾损伤患者肾功能的恢复有一定的促进作用。
목적：관찰전렬지이강화치료대노년환자심장술후급성신손상적보호작용。방법53례노년심장술후급성신손해환자，경환자지정동의，병의원윤리위원회비준，장환자분위연구조（27례）화대조조（26례）。2조균여상규약물치료，연구조재상규치료동시급여전렬지이주사액10μg＋생리염수10 ml완만정맥주사，매12 h 1차，련용7 d。관찰치료전후2조환자뇨량、뇨N-을선-β-D-안기포도당감매、뇨γ-곡안선전태매、뇨α1-미구단백（α1-MG）、혈청기항、혈뇨소담적변화，병계산2조환자중증감호병방（ ICU）정류시간、치료결속후투석치료솔，관찰사용전렬지이주사액기간적불량반응。결과여대조조상비，연구조치료후뇨량명현증다[（63．8±2．5）ml／h비（56．6±3．3）ml／h]，차이유통계학의의（P＜0．05），뇨N-을선-β-D-안기포도당감매、뇨γ-곡안선전태매、뇨α1-미구단백（1-MG）、혈청기항、혈뇨소담균명현강저，차이유통계학의의（P＜0．05）；연구조ICU정류시간단우대조조[（11±4）d비（15±3）d]，차이유통계학의의（P＜0．05），단2조치료결속후투석치료솔（3.4％비4．5％）차이무통계학의의（P＞0．05）；연구조사용전렬지이주사액기간무엄중불량반응。결론재상규치료적기출상가용전렬지이주사액치료，대노년심장술후급성신손상환자신공능적회복유일정적촉진작용。
Objective To observe the protective effect of intensive alprostadil treatment on senile patients with acute kidney injury after cardiac surgery .Methods Fifty-three senile patients with acute kidney injury after cardiac surgery were randomly divided into the study group (26 cases) and the control group (27 cases) in accordance with different treatment methods .The patients in the 2 groups were all given routine treatment , but the patients in the study groups were intravenously infused with alprostadil injection (10μg alprostadil +10ml saline) once every 12 hours, for a succession of 7 days.Changes in urine output , urinary N-acetyl-β-D-glucosamin-idase, urinaryγ-glutamyl endopeptidase, urinaryα1-microglobulin (1-MG), serum creatinine and blood urea nitrogen were observed in the patients of the 2 groups both before and after treatment .Then, the duration of stay in ICU , the rate of dialysis and adverse drug re-actions of alprostadil during the phase of medication were closely observed in the patients of the 2 groups .Results Compared with that of the control group, the urine output of the study group significantly increased [(56.6 ±3.3) ml/h∶(63.8 ±2.5) ml/h] following treatment(P>0.05).The levels of urinary N-acetyl-β-D-glucosamine glucosidase, urinary γ-glutamyl endopeptidase, urinary α1-mi-croglobulin (1-MG), serum creatinine and blood urea nitrogen were all significantly lowered , with statistical significance (P<0.05). The duration of stay in the ICU for the patients of the study group [(11 ±4)d] was shorter, as compared with that of the control group [(15 ±3)d], with statistical significance (P<0.05).However, no statistical significance could be seen in the rates of dialysis for the patients of the 2 groups following treatment (3.4%∶4.5%) (P>0.05), and no serious adverse drug reactions were seen in the pa-tients of the study group , during the time when alprostadil was administered .Conclusion Routine treatment combined with alprostadil injection could promote the recovery of renal function in patients with acute kidney injury following cardiac surgery .