参附注射液联合前列地尔治疗重症急性胰腺炎急性肾损伤

Shenfu injection combined with alprostadil in the treatment of severe acute pancreatitis and acute kidney injury

目的探讨参附注射液联合前列地尔在治疗重症急性胰腺炎患者急性肾损伤中发挥的保护作用。方法选择蚌埠医学院第一附属医院2018年6月至2020年4月间急诊外科收治的重症急性胰腺炎(Severe acute pancreatitis,SAP)合并急性肾损伤患者50例,将患者随机分为对照组(25例)和观察组(25例),其中对照组给予禁食、胃肠减压、生长抑素抑制消化酶分泌、营养支持等治疗,观察组在对照组基础上给予参附注射液联合应用前列地尔治疗。比较对照组、观察组患者第3、7天临床症状及各项检验指标变化情况,并观察记录两组患者APACHEⅡ评分、Marshall器官功能障碍评分并检测血清肾损伤分子-1(Kim-1)、血清胱抑素C(CysC)水平。结果观察组相较对照组治疗前、治疗后第3、7天尿素氮(BUN)、肌酐(Cr)、C反应蛋白(CRP)、白细胞计数(WBC)、血清淀粉酶(AMY)均有降低(P<0.01),且观察组患者在APACHEⅡ评分、Marshall器官功能障碍评分及Kim-1、CysC水平上相较对照组均降低(P<0.01)。结论参附注射液联合应用前列地尔可在一定程度上缓解SAP早期的临床症状、保护SAP合并急性肾损伤患者的肾功能,改善临床预后。

Objective TTo investigate the protective effect of Shenfu injection combined with alprostadil in the treatment of acute kidney injury in patients with severe acute pancreatitis. Methods 50 patients of Severe acute pancreatitis(Severe acute pancreatitis, SAP) merging with acute kidney injury admitted in first affiliated hospital of Bengbu Medical College from June 2018 to April 2020 emergency surgery were selected, and all patients were randomly divided into control group(25 cases) and observation group(25 cases) and the control group. The control group was given fasting, gastrointestinal decompression, somatostatin inhibiting secretion of digestive enzymes, such as nutrition support treatment, and the observation group was given Shenfu injection combined with alprostadil on the basis of treatment in the control group. The clinical symptoms and the changing situation of the test indexes and observation records on day 3 and day 7 were compared between the two groups. The APACHE Ⅱ score and Marshall organ dysfunction score of patients were recorded, and serum renal injury-1(Kim-1), serum inhibition C(CysC) levels were detected. Results Compared with the control group, urea nitrogen(BUN), creatinine(Cr), C-reactive protein(CRP), white blood cell count(WBC) and serum amylase(AMY) in observation group were decreased(P<0.01), a group of patients with APACHE Ⅱ score, Marshall organ dysfunction score were lower, the levels of KIM-1 and Cysc decreased(P<0.01). Conclusion Shenfu injection combined with alprostol can alleviate the early clinical symptoms of SAP to a certain extent, and protect the renal function of patients with SAP complicated with acute kidney injury, and improve the clinical prognosis.