连续性血液透析滤过联合托拉塞米治疗急性肾损伤的临床疗效

The clinical efficacy of continuous hemodiafiltration combined with torasemide in the treatment of acute kidney injury

目的探究连续性血液透析滤过(CVVHDF)联合托拉塞米治疗急性肾损伤(AKI)的临床疗效及对患者中性粒细胞明胶酶相关载脂蛋白(NGAL)、白细胞介素(IL)-1、IL-6水平的影响。方法选择2016年1月至2018年1月就诊于该院的100例AKI患者为研究对象,根据治疗方法的不同分为联合组和透析组,各50例。对两组患者均进行常规治疗,联合组采用CVVHDF联合托拉塞米治疗,透析组采用单独CVVHDF治疗,共治疗4周。比较两组患者临床治疗效果,NGAL、IL-1、IL-6水平,肾功能,不良反应发生率。结果治疗前,两组NGAL、IL-1、IL-6水平比较,差异无统计学意义(P>0.05);治疗前,两组血尿素氮(BUN)、血肌酐(SCr)及C反应蛋白(CRP)比较,差异无统计学意义(P>0.05)。治疗后,联合组治疗总有效率明显高于透析组,差异有统计学意义(P<0.05);治疗后,两组NGAL、IL-1、IL-6水平均降低,且联合组水平明显低于透析组,两组治疗后与治疗前及两组治疗后比较,差异有统计学意义(P<0.05);治疗后,两组BUN、SCr、CRP水平较治疗前降低,且联合组水平明显低于透析组,两组治疗后与治疗前及两组治疗后比较,差异有统计学意义(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论CVVHDF联合托拉塞米治疗AKI具有良好的临床效果,能明显降低患者NGAL、IL-1、IL-6水平,改善患者肾功能,且不良反应少,安全性较高。

Objective To explore the clinical efficacy of continuous hemodiafiltration(CVVHDF)combined with torasemide in the treatment of acute kidney injury(AKI)and the neutrophil gelatinase-related lipid loading protein(NGAL),interleukin(IL)-1,IL-6 levels.Methods From January 2016 to January 2018,100 patients in Air Force Characteristic Medical Center of PLA were selected and divided into combined group and dialysis group according to the different treatment methods,with 50 cases in each group.Patients in both groups received routine treatment,patients in combined group were treated with CVVHDF combined with torasemide,patients in dialysis group were treated with CVVHDF alone for 4 weeks.The clinical treatment effects,the levels of NGAL,IL-1 and IL-6,renal function,the incidence of adverse reactions of the two groups of patients were compared.Results Before treatment,there was no significant differences on NGAL,IL-1 and IL-6 levels between the two groups(P>0.05).Before treatment,there was no significant difference on serum urea nitrogen(BUN),serum creatinine(SCr)and C-reactive protein(CRP)(P>0.05).After treatment,the total effective rate of combined group was significantly better than that of dialysis group,and the difference was statistically significant(P<0.05).After treatment,the levels of NGAL,IL-1 and IL-6 were lower than those before treatment,and those in combined group were significantly lower than those in dialysis group,with statistical significance(P<0.05).The levels of BUN,SCr and CRP in the two groups were lower than those before treatment,and those in combined group were significantly lower than those in dialysis group,with statistical significance(P<0.05).During treatment,there was no significant difference on the incidence of adverse reactions between the two groups(P>0.05).Conclusion CVVHDF combined with torasemide has a good clinical effect on the treatment of AKI,which reduces the levels of NGAL,IL-1 and IL-6 in patients,improves the renal function of patients,has fewer adverse reactions and is safe.