血必净联合血液透析治疗蜂蜇伤致急性肾损伤的临床疗效研究

Clinical Efficacy of Xuebijing Injection Combined With Hemodialysis in Treating Acute Kidney Injury Caused by Bee Sting

目的探讨血必净联合血液透析治疗蜂蜇伤致急性肾损伤(AKI)的临床效果。方法选取2011年2月—2014年10月于攀枝花学院临床医学院、攀枝花中心医院及攀枝花攀钢集团总医院收治的蜂蜇伤致AKI患者252例为研究对象,根据治疗方法不同,将患者分为观察组(132例)和对照组(120例)。两组入院后均给予支持对症治疗,观察组予血必净50 ml+5%葡萄糖溶液250 ml静脉滴注,2次/d,连续7 d。两组患者均采用血液透析治疗,根据病情变化确定透析次数。分别于治疗前及治疗后3、7 d晨起抽取静脉血,测定血尿素氮(BUN)、血肌酐(Scr)、血清胱抑素C(Cys-C)及C反应蛋白(CRP)水平。根据患者出院时Scr水平评价临床疗效,记录少尿期持续时间及住院时间。结果治疗前后与治疗方式在BUN、Scr、Cys-C、CRP水平上存在交互作用,治疗前后在BUN、Scr、Cys-C、CRP水平上主效应显著,治疗方式在BUN、Scr、Cys-C、CRP水平上主效应显著(P<0.05)。观察组治疗后3、7 d BUN、Scr、Cys-C、CRP水平均低于治疗前(P<0.05)。观察组治疗后3、7 d BUN、Scr、Cys-C、CRP水平均低于对照组(P<0.05)。观察组总有效率高于对照组,少尿期持续时间和住院时间较对照组缩短(P<0.05)。结论血必净联合血液透析治疗蜂蛰伤所致AKI患者,可明显降低体内炎症状态,改善患者肾功能,缩短住院时间。

Objective To investigate the clinical efficacy of Xuebijing injection combined with hemodialysis in treating acute kidney injury caused by bee sting. Methods We selected 252 patients who suffered acute kidney injury caused by bee sting. Participants came from the Affiliated Hospital of Clinical Medicine College of Panzhihua University,Central Hospital of Panzhihua and Pangang Group General Hospital of Panzhihua from February 2011 to October 2014. These patients were divided into observation group（ n = 132） and control group（ n = 120） according to different treatments. The two groups were performed supportive expectant treatment after admission,and patients in observation group recieved introvenous drip of Xuebijing injection50 ml and 5% glucose solution 250 ml,2 times per day for 7 days. The two groups were also treated with hemodialysis,and the times of hemodialysis was determined according to the change of disease conditions. On the morning before and the 3rd and 7th day after treatment,we drew patients＇ venous blood to measure BUN,Scr,Cys-C and CRP levels. Clinical effect was evaluated by Scr level; duration of oliguria stage and the length of hospital stay were recorded. Results Pretherapy,post- treatment and treatment methods had an interaction effect on the levels of BUN,Scr,Cys-C and CRP（ P〈0. 05）. There were significant differences between the main effects of levels of BUN,Scr,Cys-C and CRP before and after treatment（ P〈0. 05）. The main effects of treatment mode on the levels of BUN,Scr,Cys-C and CRP were significantly different（ P〈0. 05）. The levels of BUN,Scr,Cys-C and CRP in observation group were lower in the 3rd and 7th days after treatment than before（ P〈0. 05）.After treatment,on the 3rd and 7th day,the observation group had lower levels of BUN,Scr,Cys-C and CRP than control group（ P〈0. 05）. The total effective rate in observation group was higher than control group,and duration of oliguria stage and the length of hospital stay in observation group were shorter than control group（ P〈0. 05）. Conclusion Xuebijing injection combined with hemodialysis can reduce inflammatory state, improve renal function and shorten the length of hospital stay for patients suffer acute kidney injury caused by bee sting.