摘要
目的研究乌司他丁对蜂蜇伤后急性肾损伤(AKI)的疗效及其机制。方法将我科59例患者随机分为对照组(29例)和治疗组(30例),两组给予常规治疗,治疗组在此基础上加用乌司他丁,疗程7 d。观察两组患者死亡率和痊愈率、少尿期持续时间,并观察治疗前和治疗7 d后急性生理学与慢性健康状况评分(APACHE)Ⅱ、血肌酐(Scr)、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、血浆肿瘤坏死因子(TNF)α、白介素(IL)-1β和IL-10的水平。结果两组患者死亡率比较,差异无统计学意义(P>0.05),治疗组痊愈率高于对照组(93.1%vs.71.4%,P=0.041),少尿期持续时间治疗组短于对照组〔(21.8±2.7)d vs.(24.8±2.6)d,P=0.0001〕。治疗前两组患者APACHEⅡ、Scr、NAG、TNF-α、IL-1β和IL-10水平差异无统计学意义(P>0.05);治疗7 d后,治疗组APACHⅡ〔(9.46±1.43)vs.(11.04±1.84)〕、Scr〔404.3(366.4,470.0)vs.522.4(438.9,574.7)μmol/L〕、NAG〔(40.77±10.87)vs.(49.49±16.23)U/L〕、TNF-α〔(112.62±32.37)vs.(141.76±53.44)μg/L〕和IL-1β〔(18.01±6.25)vs.(22.04±5.17)pg/ml〕水平均较对照组低,差异有统计学意义(P<0.05),IL-10水平较对照组高〔(75.35±12.38)vs.(68.56±11.01)pg/ml〕,差异有统计学意义(P<0.05)。结论乌司他丁通过减轻肾小管损伤、下调TNF-α、IL-1β水平和上调IL-10水平,减轻毒蜂蜇伤后AKI。
Objective To study the effect of ulinastatin on acute kidney injury(AKI) and its mechanism following wasp stings.Methods Fifty-nine patients were divided randomly into groups control(n=29) and treatment(n=30).Two groups were treated with conventional therapy,but treatment group with additional ulinastatin injection.Mortality,recovery rates,duration of oliguria observed,and the scores of Acute Physiology and Chronic Health Evaluation(APACHE) II,levels of serum creatinine(scr),urinary N-acetyl-β-glucosaminidase(NAG),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β and IL-10 compared between 2 groups before treatment and 7 days after.Results No significant difference was noted in mortality between 2 groups(P0.05).Recovery rate was higher in group treatment than in control(93.1% vs.71.4%,P=0.041),and duration of oliguria shorter((21.8±2.7)vs.(24.8±2.6)d,respectively,P=0.0001).There was not significant difference in APACHE Ⅱ,Scr,NAG,TNF-α,IL-1β,IL-10 between 2 groups before treatment(P0.05).And 7 d after,treatment group were lower than control in APACH Ⅱscores(9.46±1.43)vs(11.04±1.84),Scr(404.3(366.4,470.0)vs.522.4(438.9,574.7)μmol/L),NAG((40.77±10.87)vs.(49.49±16.23)U/L),TNF-α((112.62±32.37)vs.(141.76±53.44)μg/L) and IL-1β((18.01±6.25)vs.(22.04±5.17)pg/ml),the difference was significant(P0.05),and higher in IL-10((75.35±12.38)vs.(68.56±11.01)pg/ml,P0.05).Conclusion Ulinastatin can alleviate AKI following wasp stings by reducing renal tubule damage,down-regulating TNF-α and IL-1β and up-regulating IL-10.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第23期2726-2728,共3页
Chinese General Practice
关键词
乌司他丁
蜂蜇伤
急性肾损伤
炎性因子
Ulinastatin
Wasp stings
Acute kidney injury
Inflammatory factor