乌司他丁在先心病小儿体外循环期早期肾保护的临床研究

目的探讨乌司他丁不同剂量、不同给药方式对于先心病小儿体外循环术后早期肾功能损伤的保护效果。方法选取室间隔缺损的先天性心脏病患儿75例,根据乌司他丁不同剂量、不同给药方式分为4个实验组,每组各15例,另设对照组15例,不注射乌司他丁,注射等量生理盐水。比较5组患儿术后肾功能保护效果。结果各组患儿在手术前(T1)各项指标差异无统计学意义,具有可比性;术后4个时间点,4个实验组各项指标均显著低于对照组,同时刻组间比较,NAG的F值分别为2.038、3.952、3.043、5.329,尿素氮F值分别为1.368、2.249、3.842、3.073,血肌酐F值分别为1.644、2.583、4.085、4.745,差异具有统计学意义(P<0.05);实验Ⅳ组较其他3个实验组指标上升幅度小,差异具有统计学意义(P<0.05)。结论乌司他丁有利于小儿体外循环术后早期肾功能损伤的保护。

Objective To investigate the protective effect of different administration methods for early renal injury in children with congenital heart disease after cardiopulmonary bypass and different doses of ulinastatin. Methods 75 cases of congenital heart disease in children with ventricular septal defect were selected, according to the different dose of ulinastatin, different administration methods are divided into 4 groups, 15 cases in each group, the control group of 15 cases, no injection of ulinastatin, injected with saline. Protective effect of renal function were compared between the 5 groups after the. Results Each group before surgery （T 1） there was no significant difference between the indicators, comparable; 4 time points after operation, the 4 experimental groups were significantly lower than the control group, F value for NAG were 2.038, 3.952, 3.043, 5.329, for urea nitrogen were 1.368, 2.249, 3.842, 3.073, and for serum creatinine were 1.644, 2.583, 4.085, 4.745, the difference was statistically significant （P〈 0.05）; Experiment IV group than in the other 3 groups index rise, the difference was statistically significant （P〈0.05）.Conclusion Ulinastatin can protect the renal function damage for early in children after cardiopulmonary bypass.