肾康注射液联合羟苯磺酸钙胶囊治疗原发性肾病综合征并发急性肾损伤疗效及对凝血-纤溶系统的影响

Therapeutic effect of Shen Kang Injection combined with Calcium Dobesilate Capsules on primary nephritic syndrome complicated with acute kidney injury and its influence on coagulation fibrinolysis system

目的观察肾康注射液联合羟苯磺酸钙胶囊治疗原发性肾病综合征(PNS)并发急性肾损伤(AKI)的疗效及对凝血-纤溶系统的影响。方法将76例PNS合并AKI患者随机分为观察组38例和对照组38例,2组均给予常规治疗,对照组在常规治疗基础上给予羟苯磺酸钙胶囊治疗,观察组在对照组治疗基础上加用肾康注射液治疗,疗程为14 d。观察2组治疗前及治疗第7,14天血清学、尿液学、肾脏超声检查学指标变化情况,检测凝血-纤溶系统相关指标水平,并记录治疗疗效。结果 2组治疗第7,14天血清肌酐(SCr)、尿素氮(BUN)、血清白蛋白(ALB)、24 h尿蛋白定量(24 h TP)、尿N-乙酰-β-D氨基酸葡萄糖苷酶(NAG)、肾脏损伤因子-1(KIM-1)、肾动脉内径(D)、肾动脉收缩期最大血流速(V_(max))、肾动脉阻力指数(RI)、凝血指标(TT、APTT、FIB、FBI)、纤溶指标(t-PA、PAI-1、vWF、D-D)均显著改善(P均<0.05),且除凝血指标外观察组上述指标改善情况均优于对照组(P均<0.05);观察组治疗第7,14天治疗有效率均高于对照组(P均<0.05)。结论在羟苯磺酸钙胶囊治疗PNS并发AKI基础上,加用肾康注射液治疗可提高治疗疗效,改善肾脏血流动力学,保护肾功能,其机制可能与其促进凝血-纤溶系统的平衡有关。

Objective It is to observe the therapeutic effect of Shen Kang Injection combined with Calcium Dobesilate Capsules on primary nephritic syndrome （PNS） complicated with acute kidney injury （AKI） and its influence on the coagulation fibrinolysis system. Methods 76 patients with PNS complicated with AKI were randomly divided into observation group （38 cases） and control group （38 cases） , on the basis of conventional treatment, the control group was treated with Calcium Do- besilate Capsules, ang the observation group was treated with Shen Kang Injection combined with Calcium Dobesilate Cap- sules, the course of treatment was 14 days. The changes of serology, urine and renal ultrasonography in two groups were ob- served before treatment and 7-and 14-day after treatment, the level of related indexes of coagulation fibrinolysis system was de- termined, and the therapeutic effect was recorded. Results After 7-and 14-day treatment, the levels of serum ereatinine （SCr） , blood urea nitrogen （ BUN ） , serum albumin （ ALB ） , 24h urinary protein （24hTP） , urinary N-acetyl-beta-D-glu- cosaminidase （NAG）, kidney injury molecule-1 （KIM-1）, renal artery diameter （D）, kidney arterial peak systolic blood flow velocity （Vmax） , renal artery resistance index （RI） , blood coagulation index （TT, APTT, FIB, FBI） and fibrinolysis indexes （t-PA, PAl-l, vWF, D-D） were significantly improved （all P 〈0.05）, and the improvement of the indexes in the observation group was signioficantly better than that in the control group （P 〈 0.05） ; the effective rate of the treatment group were significantly higher than that in the control group after treated for 7-and 14-day （ all P 〈 0.05 ）. Conclusion Based on Calcium Dobesilate Capsulesg treatment of PNS concurrent AKI, treatment with Shen Kang Injection can enhance the curative effect, improve renal hemodynamics, protect renal function, its mechanism may be related to promoting the balance of coagula- tion fibrinolysis system.