前列地尔注射液治疗慢性心力衰竭并发急性肾损害的临床疗效观察

Clinical Efficacy of Alprostadil Injection for Acute Kidney Injury in Patients with Chronic Heart Failure

目的:探讨前列地尔注射液对慢性心力衰竭并发急性肾损害的疗效。方法:180例慢性心力衰竭并发急性肾损害患者,按随机数字法分为观察组(前列地尔组,n=60)和对照组(n=60),2组均予常规治疗,观察组在常规治疗基础上联合前列地尔注射液10μg、bid+0.9%氯化钠注射液10 mL缓慢静脉注射,连续7 d。记录治疗后3、5、7 d患者血肌酐(Cr)、血尿素氮(BUN)、肌酐清除率(Ccr)、尿量,并计算2组患者重症监护病房(ICU)停留时间;使用前列地尔注射液期间观察药品不良反应。结果:观察组总有效率为90.0%(54/60),对照组总有效率为66.7%(40/60),2组比较,差异有统计学意义(P<0.05)。与治疗前比较,治疗后3、5、7 d,2组患者Cr、BUN均明显降低(P均<0.05);治疗后3、5、7 d观察组患者Ccr和尿量比治疗前明显增加(P均<0.05),与对照组治疗后上述指标比较,观察组改善更为明显(P均<0.05)。观察组ICU停留时间显著短于对照组(P<0.05);治疗后观察组心功能级别平均值为1.28±0.39,对照组心功能级别平均值为3.17±0.69,2组比较,差异有统计学意义(P<0.05)。结论:在常规治疗基础上加用前列地尔注射液治疗慢性心力衰竭并发急性肾损害,对患者肾功能的恢复具有一定促进作用,并能积极控制原发病,控制心力衰竭进展。

OBJECTIVE：To evaluate the clinical efficacy of alprostadil injection for acute kidney injury（AKI） in patients with chronic heart failure.METHODS：A total of 180 AKI patients with chronic heart failure were randomly divided into the control group and the trial group of 60 each.Both group received routine therapy while patients in the trial group were additionally given alprostadil injection（10 μg i.v.） for 7 days.At 3,5 and 7 days,serum creatinine（Cr）,blood urea nitrogen（BUN）,creatinine clearance rate（Ccr）,urine volume,ICU stay duration and adverse reactions of alprostadil injection were recorded.RESULTS：There were significant differences between the trial group and the control group in total response rate [90.0%（54/60） vs.66.7%（40/60）,P0.05].As compared with before treatment,at 3,5 and 7 days,the Cr and BUN levels in both groups showed significant decline（P0.05 for all）;Ccr and urine volume at 3,5 and 7 days in the trial group showed significant increase（P0.05 for all）,with the trial group showing better improvement in the above indexes（P0.05）.The ICU stay duration in the trial group was significantly shorter than in the control group（P0.05）.Significant differences were noted in the mean value for cardiac function level between the trial group and the control group [（1.28±0.39）vs.（3.17±0.69）,P0.05].CONCLUSION：The addition of alprostadil injection to routine therapy may promote the recovery of renal function in patients with chronic heart failure associated with acute kidney injury,keep the primary disease under control and delay the progression of the cardiac failure.