肾康注射液联合左西孟旦治疗冠状动脉搭桥术后早期急性肾损伤的疗效观察

Clinical observation of Shenkang Injection combined with levosimendan in treatment of early acute renal injury after bypass operation of coronary artery

目的探讨肾康注射液联合左西孟旦治疗冠状动脉搭桥术后早期急性肾损伤的临床效果。方法收集2011年3月—2016年7月在安阳市人民医院接受诊治的冠状动脉搭桥术后急性肾损伤患者122例,随机分为对照组(61例)和治疗组(61例)。对照组患者静脉注射左西孟旦注射液,初始剂量10μg/kg,持续10 min,此后以0.1~0.2μg/(kg·min)的速度持续23 h。治疗组在对照组的基础上静脉滴注肾康注射液,10 m L加到5%葡萄糖注射液100 m L中,1次/d。两组患者均连续治疗7 d。评价两组患者临床疗效,同时比较两组患者治疗前后24 h尿蛋白、尿微量白蛋白、血清尿素氮、血肌酐和肾小球滤过率(GFR)变化。结果治疗后,对照组和治疗组的总有效率分别为70.49%、85.25%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组患者24 h尿蛋白和尿微量白蛋白均比治疗前显著下降,同组比较差异具有统计学意义(P<0.05);且治疗后治疗组患者24 h尿蛋白和尿微量白蛋白水平优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血尿素氮、血肌酐均较治疗前显著降低,两组GFR显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组患者尿素氮、血肌酐和GFR水平均优于对照组,两组比较差异具有统计学意义(P<0.05)。结论肾康注射液联合左西孟旦治疗冠状动脉搭桥术后急性肾损伤疗效确切,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Shenkang Injection combined with levosimendan in treatment of early acute renal injury after bypass operation of coronary artery.Methods Patients （122 cases） with early acute renal injury after bypass operation of coronary artery in the People＆#39;s Hospital of Anyang from March 2011 to July 2016 were randomly divided into control （61 cases） and treatment （61 cases） groups. Patients in the control group were ivadministered with Levosimendan Injection, the initial dosage was 10μg/kg for 10 min, then at the rate of 0.1—0.2μg/（kg＆#183;min） for 23 h. Patients in the treatment group were ivadministered with Shenkang Injection on the basis of the control group, 10 mL added into 5% glucose injection 100 mL, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the change of 24 h urinary protein, urinary microalbumin, serum urea nitrogen and creatinine in two groups before and after treatment were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 70.49% and 85.25% respectively, and there was difference between two groups （P 〈 0.05）. After treatment, the 24 h urinary protein and urinary microalbumin in the treatment group were significantly decreased, the difference was statistically significant in the same group （P 〈 0.05）. And the 24 h urinary protein and urinary microalbumin in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, blood urea nitrogen and serum creatinine in two groups were significantly decreased, but GFR in two groups was significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And after treatment the serum urea nitrogen, creatinine and GFR in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）.Conclusions Shenkang Injection combined with levosimendan has a significant curative effect in treatment of early acute renal injury after bypass operation of coronary artery, which has a certain clinical application value.