左西孟旦联合甘油果糖对冠状动脉搭桥术后早期急性肾损伤的治疗效果与安全性分析

Treatment effect and safety analysis in early acute renal injury after coronary artery bypass grafting surgery by levosimendan combined with glycerol fructose

目的探讨左西孟旦联合甘油果糖治疗冠状动脉搭桥术后早期急性肾损伤(acute kidney injury,AKI)的疗效与安全性.方法选取2012年12月至2016年12月于齐齐哈尔医学院附属第三医院心胸外科接受冠状动脉搭桥术的126例患者作为研究对象,采用随机数字表法将其分为观察组与对照组,对照组63例术后早期应用左西孟旦注射液治疗,观察组63例则在对照组治疗方案的基础上联合应用甘油果糖注射液治疗,比较两组患者治疗前后心、肾功能损害情况及不良反应发生情况.结果所有患者均顺利完成冠状动脉搭桥术治疗,观察组术后早期AKI患者治疗后总有效率明显高于对照组(88.89%vs.69.84%,P<0.05);治疗前两组患者左室射血分数(LVEF)、左室短轴缩短率(LVFS)比较差异无统计学意义(P>0.05),治疗后观察组患者LVEF(%)和LVFS(%)指标改善效果明显高于对照组(40.88±5.39 vs.36.53±5.49及30.26±6.07 vs.24.34±7.59,P均<0.05);两组患者治疗期间均未发生任何严重不良反应或并发症.结论采用左西孟旦联合甘油果糖可有效治疗冠脉搭桥术后早期AKI,可快速、积极改善患者肾功能,遏制肾损伤的进行性发展,并且药物应用安全、可靠,具有应用及推广价值.

Objective Purpose to discuss the treatment effect and safety analysis in early acute renal injury after coronary artery bypass grafting surgery by Levosimendan combined with glycerol fructose.Methods Atotal of 126 cases of patients undergoing coronary artery bypass grafting were collected as study subjects from December 2012 to December 2016 in our hospital department of cardiothoracic surgery.By random number table method,they were divided into observation group and control group.There were 63 cases of patients in control group,all the patients were treated by levosimendan injection.There were 63 cases of patients in observation group,based on the treatment of control group.They were glycerol and fructose injection treatment.The heart and renal dysfunction and adverse reactions of the two groups before and after treatment were compared.Results All patients successfully completed coronary artery bypass grafting,there was statistical significance in the total effective rate of the patients with acute renal injury after operation(88.89%vs.69.84%,P<0.05).There was no significant difference in LVEF(%)and LVFS(%)between the two groups before treatment(P>0.05).After treatment,the improvement effect of LVEF and LVFS in observation group was significantly higher than control group(40.88±5.39 vs.36.53±5.49,30.26±6.07 vs.24.34±7.59,P<0.05).There were no serious adverse reactions or complications occurred in both groups during treatment.Conclusion Levosimendan combined with glycerol fructose can effectively treat acute renal injury after coronary artery bypass grafting,can quickly and actively improve the patient's renal function,can stop the progressive development of kidney damage,and safe,reliable,with the application and promotion of value.