阿魏酸哌嗪联合血液透析治疗肾综合征出血热伴急性肾衰竭的临床效果

Clinical effect of piperazine ferulate combined with hemodialysis in the treatment of hemorrhagic fever with renal syndrome accompanied by acute renal failure

目的 分析阿魏酸哌嗪联合血液透析(HD)治疗肾综合征出血热(HFRS)伴急性肾衰竭(ARF)的临床效果。方法 选取2018年1月至2020年1月收治的80例HFRS伴ARF患者为研究对象,根据随机数字表法将其分为对照组和观察组,各40例。对照组接受HD治疗,观察组在对照组基础上接受阿魏酸哌嗪治疗。比较两组的治疗效果。结果 观察组的血肌酐(Scr)恢复时间、血尿素氮(BUN)恢复时间、尿蛋白消退时间短于对照组,差异具有统计学意义(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗后,观察组的Scr、BUN、β_(2)-微球蛋白(β_(2)-MG)、纤维连接蛋白(FN)、内皮素、可溶性细胞间黏附分子-1(sICAM-1)水平低于对照组,估算肾小球滤过率(eGFR)高于对照组,循环内皮细胞数量少于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的肾动脉内径、收缩期平均流速大于对照组,阻力指数小于对照组(P<0.05)。结论 阿魏酸哌嗪联合HD治疗HFRS伴ARF可有效改善肾功能,且不增加不良反应。

Objective To analyze the clinical effect of piperazine ferulate combined with hemodialysis(HD)in the treatment of hemorrhagic fever with renal syndrome(HFRS)accompanied by acute renal failure(ARF).Methods A total of 80 patients with HFRS accompanied by ARF admitted from January 2018 to January 2020 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 40 cases in each group.The control group received HD treatment,and the observation group received piperazine ferulate treatment on the basis of the control group.The therapeutic effects of the two groups were compared.Results The serum creatinine(Scr)recovery time,blood urea nitrogen(BUN)recovery time and urinary protein regression time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After treatment,the levels of Scr,BUN,β_(2)-microglobulin(β_(2)-MG),fibronectin(FN),endothelin and soluble intercellular adhesion molecule-1(sICAM-1)in the observation group were lower than those in the control group,the estimated glomerular filtration rate(eGFR)was higher than that in the control group,the number of circulating endothelial cells was less than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the renal artery diameter and average systolic velocity in the observation group were larger than those in the control group,the resistance index was smaller than that in the control group(P<0.05).Conclusion Piperazine ferulate combined with HD in the treatment of HFRS accompanied by ARF can effectively improve renal function without increasing adverse reaction.