曲美他嗪配合常规抗休克方案治疗休克时改善肾功能的作用分析

Analysis of renal function improvement effect of Qumei trimetazidine combined with routine anti shock regimen in the treatment of shock

目的:探讨休克患者采用曲美他嗪辅助常规抗休克治疗对肾功能的保护作用。方法:将2012-03-2014-03我院重症监护病房收治的62例因各种原因引起休克的患者采用随机数字表法分为研究组和对照组,各31例。2组均采用常规的抗休克治疗方案,研究组患者加用曲美他嗪(20mg口服,3次/d),比较2组患者治疗前后不同时间的肾功能指标及相关血流动力学指标的变化情况。结果:研究组和对照组治疗后48h、第7天的尿量较本组治疗前显著升高,血肌酐(SCr)、尿素氮(BUN)、血清胱抑素C(CysC)、血乳酸(LAC)、尿素-谷氨酸转肽酶(γ-GTP)值较治疗前显著降低(P<0.05);治疗后第7天研究组的SCr、BUN、CysC、LAC、γ-GTP值较对照组显著降低(P<0.05)。研究组和对照组治疗后48h的平均动脉压(MAP)、中心静脉血氧饱和度(ScvO_2)值较治疗前显著提高(P<0.05),心率(HR)较治疗前显著降低(P<0.05);2组的丙二醛(MDA)值在治疗后48h、第7天较治疗前显著降低,血超氧化物歧化酶(SOD)较治疗前显著升高(P<0.05);治疗后第7天研究组患者的SOD、MDA值显著优于对照组(P<0.05)。结论:常规抗休克治疗辅以曲美他嗪能够进一步改善休克患者的肾功能。

Objective：To investigate the renal fuction protective effect of Qumei trimetazidine auxiliary routine anti shock treatment in patients with shock.Method：Sixty-two cases with shock caused by various reasons admitted to the ICU of out hospital from March 2012 to March 2014 were randomly divided into study group and control group with 31 cases in each group.The routine anti shock treatment was used in both groups.Qumei trimetazidine（20mg orally,3times/d）was added in study group.Changes of the renal function indexes and relevant hemodynamic indexes before and after treatment in two groups were compared.Result：Urine volume of 48 h,7dafter treatment was significantly increased than that before treatment in both groups.SCr,BUN,CysC,LAC,γ-GTP values were significantly lower（P〈0.05）.SCr,BUN,CysC,LAC,γ-GTP value of study group on the 7dafter treatment were significantly decreased than that of the control group and the difference has statistical significance（P〈0.05）.MAP,ScvO_2 value of 48 hafter treatment were increased significantly compared with those before treatment（P〈0.05）in both groups.HR after treatment were significantly lower than those before therapy（P〈0.05）.The study group and the control group in the MDA values of 48 h,7dafter the treatment were significantly decreased than that before treatment in both groups.SOD was increased significantly.And the differences were statistically significant（P〈0.05）.In study group,SOD,MDA values of 7dafter treatment were significantly better than that in the control group and the difference was statistically significant（P〈0.05）.Conclusion：Conventional anti shock treatment combined with Qumei trimetazidine can further improve the renal function of patients with shock.