参芪扶正注射液对体外循环心脏手术后尿微量蛋白及尿酶的影响

Effects of Shenqi Fuzheng injection on urine microalbumin and urease after cardiac surgery with cardiopulmonary bypass

目的观察参芪扶正注射液对体外循环心脏手术后患者尿微量清(白)蛋白(m-Alb)、β2-微球蛋白(β2-MG)及N-乙酰-β-D氨基葡萄糖苷酶(NAG)的影响。方法二尖瓣置换术患者40例随机分为2组,每组20例。试验组在麻醉前30min静脉滴注参芪扶正注射液250mL、氧合器中加入125mL、术后3d内每日静脉滴注参芪扶正注射液250mL;对照组以等容量平衡液替代参芪扶正注射液。2组均在术前及术后1、3、5、7d测定尿m-Alb、β2-MG及NAG水平。结果2组患者术后1、3、5d尿m-Alb、β2-MG和NAG值均高于术前(P<0.05),且同一时点,试验组均低于对照组(P<0.05)。术后7d,试验组尿m-Alb和β2-MG值已恢复到术前水平,对照组仍然偏高(P<0.05)。2组均无不良反应发生。结论参芪扶正注射液对体外循环心脏手术患者肾脏功能有一定的保护作用。

AIM To observe the effects of Shenqi Fuzheng injection on urine microalbumin （m-Alb）, beta-2-microglobulin （ β2-MG） and N-acetyl-beta-D-glucosaminidase （ NAG） in patients after cardiac surgery with cardiopulmonary bypass. METHODS Forty patients undergoing mitral valve replacement were randomly divided into trial group （n = 20） and control group （n = 20）. The patients in the trial group were intravenously infused Shenqi Fuzheng injection 250 mL 30 min before anesthesia and another 125 mL of the same injection were kept in oxgenator, and followed by 250 mL of the same agent iv gtt once daily for three days after the operation. Equal volume balanced solution was received individually in the control group instead of Shenqi Fuzheng injection. Urinary m-Alb, β2-MG and NAG were measured in both groups at the same time points before anesthesia and 1, 3, 5, 7 d after operation. RESULTS The levels of urinary m-Alb, β2-MG and NAGin the both groups postoperatively at 1, 3, 5 d were higher than those before anesthesia （P 0.05）. However, these values in the trial group were lower than those in the control group （P 0.05）. At postoperative 7 d, the values of urinary m-Alb and NAG in the control group were still higher than preoperative values （P 0.05）, however, the values of the trial group had returned to the preoperative levels. There were no serious adverse reactions occurred in both group. CONCLUSION Shenqi Fuzheng injection provides protective effects on renal function for patients undergoing cardiac surgery with cardiopulmonary bypass.