参附注射液对脓毒性休克患者急性肾损伤的保护作用

Protective Effects of Shenfu Injection on Acute Kidney Injury of Patients with Septic Shock

目的观察参附注射液对脓毒性休克患者急性肾损伤的保护作用。方法将患者60例按随机数字表法分为治疗组及对照组,各30例。均按2012年国际脓毒性休克指南行集束化治疗,治疗组加用参附注射液60 m L加入0.9%氯化钠注射液250 m L静滴,对照组加用等量的0.9%氯化钠注射液,两组疗程均为7 d。分别检测两组治疗前和治疗后第3、7日血清肌酐(Cr)、尿素氮(BUN)、胱抑素C、前降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、尿β2-微球蛋白(β2-MG)及24 h尿微量白蛋白(UPRO/24 h),同时记录治疗前后急性生理与慢性健康评分(APACHEⅡ评分)和器官功能衰竭评分(SOFA评分)。结果治疗组血清胱抑素C在第7日低于对照组(P<0.05);治疗组PCT在第3、7日低于对照组(P﹤0.05);治疗组β2-MG、UPRO/24 h在第7日均低于对照组(P<0.05);治疗组APACHEⅡ评分在第3、7日低于对照组(P<0.05),而SOFA评分在第7日低于对照组(P<0.05)。结论参附注射液对脓毒性休克所致的急性肾损伤有保护作用。

Objective： To explore the protective effects of Shenfu injection on acute kidney injury of patients with septic shock. Methods： 60 patients with septic shock were randomized to the treatment group and the con-trol group,with 30 in each. All patients were treated with sepsis bundle according to International guidelines for septic shock 2012. The treatment group was treated with Shenfu injection,60 mL,250 mL 0.9%,sodium chloride injection,intravenous drip,while the control group were given an equal amount of 0.9%sodium chloride injection. The course of treatment was 7 days. Before treatment and on 3rd and 7th day after treatment,the levels of serum creatinine （sCr）,blood urea nitrogen （BUN）,cystatin C, procalcitonin （PCT）,C-reactive protein （CRP）,tumor necrosis factor-alpha （TNF-α）,β2-microglobulin and 24-hour urine protein were measured respectively and A-PACHEⅡ score and SOFA score were recorded before and after treatment. Results： The serum cystatin C in the treatment group was lower than that in the control group on the seventh day（P〈0.05）;PCT of the treatment group was lower than that of the control group on 3rd and 7th day（P〈0.05）;the levels of beta 2-MG and UPRO/24 h in the treatment group were lower than those in the control group at seventh days （P〈0.05）;APACHEⅡ scores in the treatment group were lower than those in the control group on 3rd and 7th day （P〈0.05）,while SOFA score was lower than that in the control group at seventh days （P〈0.05）. Conclusion： Shenfu injection has a protec-tive effect on acute kidney injury caused by septic shock.