不同剂量乌司他丁对急性肾损伤患者肾功能、炎症及氧化应激指标的改善作用

Improvement effects of ulinastatin with different doses on indicators of renal function,inflammation and oxidative stress in patients with acute kidney injury

目的探讨不同剂量乌司他丁对急性肾损伤患者的肾功能、炎症及氧化应激指标的改善作用。方法将120例急性肾损伤患者随机分为常规治疗组、常规剂量乌司他丁组及大剂量乌司他丁组,每组40例。3组患者均接受常规治疗,常规剂量乌司他丁组及大剂量乌司他丁组分别给予10万单位/次、100万单位/次的乌司他丁。治疗前及治疗15d后,比较3组患者的肾功能指标、炎症指标及氧化应激指标。结果治疗15d后,3组的肾功能指标、炎症指标及氧化应激指标均较治疗前改善(均P<0.05),常规治疗组、常规剂量乌司他丁组、大剂量乌司他丁组血清肌酐、胱抑素C、白细胞介素(IL)-6、IL-8、肿瘤坏死因子α、晚期氧化蛋白产物和丙二醛水平依次下降,而尿量及超氧化物歧化酶依次增加(均P<0.05)。结论乌司他丁能改善急性肾损伤患者的肾功能,抑制患者机体炎症及氧化应激反应,且大剂量效果更佳。

Objective To investigate the improvement effects of ulinastatin with different doses on indicators of renal function,inflammation and oxidative stress in patients with acute kidney injury. Methods A total of 120 patients with acute kidney injury were randomly divided into conventional treatment group,normal-dose ulinastatin group and high-dose ulinastatin group,with 40 cases in each group.Patients in the three groups all received conventional treatment,besides, the normal-dose and high-dose ulinastatin groups were administered ulinastatin with the doses of 10×10 4 U and 100×10 4 U , respectively .Before treatment and after 15 days of treatment,patients in the three groups were compared in terms of indicators of renal function,inflammation and oxidative stress. Results Fifteen days after treatment,the indicators of renal function,inflammation and oxidative stress in the three groups were improved compared to the indicators before treatment(all P <0.05),the levels of serum creatinine,cystatin C, interleukin(IL)-6,IL-8,tumor necrosis factor α, advanced oxidation protein products and malondialdehyde decreased,while urine volume and superoxide dismutase increased in the order of the conventional treatment group,the normal-dose ulinastatin group and the high-dose ulinastatin group(all P <0.05). Conclusion Ulinastatin not only can improve renal function,but also can inhibit inflammation and oxidative stress response in the body of patients with acute renal injury,and high-dose ulinastatin obtains a better efficacy.