乌司他丁联合连续性肾脏替代疗法在脓毒症合并急性肾损伤患者中的应用效果及对炎症、应激、肾功能指标的影响

Application effect of ulinastatin combined with continuous renal replacement therapy in patients with sepsis complicated with acute kidney injury and its influences on inflammation,stress and renal function indexes

目的探究乌司他丁联合连续性肾脏替代疗法在脓毒症合并急性肾损伤患者中的应用效果。方法选取我院收治的58例脓毒症合并急性肾损伤患者为研究对象,采用抽签法将其分为参照组和研究组,各29例。参照组实施连续性肾脏替代疗法,研究组在参照组基础上给予乌司他丁。比较两组的治疗效果。结果治疗2周后,两组的降钙素原(PCT)、C-反应蛋白(CRP)、丙二醛(MDA)水平均降低,谷胱甘肽过氧化物酶(GSH-Px)水平均升高,且研究组优于参照组(P<0.05)。治疗2周后,两组的金属基质蛋白酶组织抑制因子-2(TIMP-2)、可溶性髓样细胞触发受体-1(sTREM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)、肾损伤分子-1(KIM-1)、基质金属蛋白酶-9(MMP-9)水平均降低,胱抑素C(CysC)水平均升高,且研究组优于参照组(P<0.05)。研究组的连续性肾脏替代疗法时间、住院时间短于参照组(P<0.05);治疗2周后,研究组的感染相关性器官功能衰竭评价(SOFA)评分低于参照组(P<0.05)。结论乌司他丁联合连续性肾脏替代疗法在脓毒症合并急性肾损伤患者中的应用效果显著,可有效减轻机体炎症及应激反应,改善肾功能,促进病情转归。

Objective To explore the application effect of ulinastatin combined with continuous renal replacement therapy in patients with sepsis complicated with acute kidney injury.Methods A total of 58 patients with sepsis complicated with acute kidney injury admitted in our hospital were selected as the research objects,and the patients were divided into reference group and study group by drawing lots,with 29 cases in each group.The reference group was treated with continuous renal replacement therapy,and the study group was given ulinastatin on the basis of the reference group.The therapeutic effects of the two groups were compared.Results After 2 weeks of treatment,the levels of procalcitonin(PCT),C-reactive protein(CRP)and malondialdehyde(MDA)in the two groups decreased,and the level of glutathione peroxidase(GSH-Px)increased,and those in the study group were better than the reference group(P<0.05).After 2 weeks of treatment,the levels of tissue inhibitor of matrix metalloproteinase-2(TIMP-2),soluble triggering receptor expressed on myeloid cells-1(sTREM-1),neutrophil gelatinase associated lipocalin(NGAL),liver fatty acid binding protein(L-FABP),kidney injury molecule-1(KIM-1)and matrix metalloproteinase-9(MMP-9)in the two groups decreased,the level of cystatin C(CysC)increased,and those in the study group were better than the reference group(P<0.05).The continuous renal replacement therapy time and hospitalization time of the study group were shorter than those of the reference group(P<0.05);after 2 weeks of treatment,the Sepsis Related Organ Failure Assessment(SOFA)score of the study group was lower than that of the reference group(P<0.05).Conclusion The ulinastatin combined with continuous renal replacement therapy in patients with sepsis complicated with acute kidney injury has a significant application effect,which can effectively reduce the body's inflammation and stress response,improve the renal function,and promote the prognosis of the disease.