血必净对泌尿系统结石患者经皮肾镜钬激光碎石术后肾损伤标志物和IL-6、IL-18、CRP水平的影响

Effects of Xuebijing on renal injury markers and serum IL-6,IL-18 and CRP concentrations in patients with urinary calculi after percutaneous neplrolithotripsy

目的探讨血必净对泌尿系统结石患者经皮肾镜钬激光碎石术(MPCNL)后肾损伤标志物和白介素-6(IL-6)、白介素-18(IL-18)、C反应蛋白(CRP)水平的影响。方法选取2015年2月至2017年3月该院择期行MPCNL术泌尿系统结石患者110例,随机分为观察组、对照组各55例,术后对照组常规治疗,观察组另静脉滴注血必净注射液,均治疗2周,记录两组手术一般情况,对比两组临床疗效及治疗前后血肌酐(Scr)、肌酐清除率(GFR)、肾损伤因子-1(KIM-1)与血清IL-6、IL-18、CRP水平,并观察术后并发症与不良反应。结果观察组住院时间、白细胞复常时间、拔除肾造瘘管时间短于对照组(P<0.05);观察组治疗有效率83.64%明显高于对照组65.45%(P<0.05);观察组治疗后Scr(45.21±0.77)μmol/L、KIM-1(3.20±0.11)μg/L及血清IL-6(0.45±0.13)ng/mL、IL-18(0.30±0.12)ng/mL、CRP(0.10±0.03)mg/L低于对照组,而GFR(120.48±1.56)mL/min明显高于对照组(P<0.05);观察组术后并发症发生率1.82%明显低于对照组12.73%(P<0.05),两组不良反应发生率5.45%、3.64%比较差异无统计白细胞复常时间学意义(P>0.05)。结论血必净可明显改善泌尿系统结石患者MPCNL术后肾损伤标志物和IL-6、IL-18、CRP水平,降低术后相关并发症,不会增加药物不良反应,值得在临床推广应用。

Objective To explore the effects of Xuebijing on renal injury markers and the serum concentrations of interleukin-6(IL-6),interleukin-18(IL-18)and C reactive protein(CRP)in patients with urinary calculi after percutaneous nephrolithotripy(MPCNL).Methods Totally 110 patients with urinary calculi treated with MPCNL in our hospital from February 2015 to March 2017 were randomly divided into the observation group and the control group and 55 patients were in each group.The control group was given routine treatments after operation,and the observation group was additionally given intravenous drip of Xuebijing injection.And the two groups were treated for 2 weeks.The general data of operation were recorded for the two groups,and the clinical efficacy of the two groups and the concentrations of serum creatinine(Scr),creatinine clearance rate(GFR),renal injury factor-1(KIM-1)and serum IL-6,IL-18 and CRP were measured and compared before and after treatment,and the postoperative complications and adverse reactions were observed.Results The length of hospital stay,the leukocyte normalization time and the removal time of renal fistula in the observation group were shorter than those in the control group(P<0.05).The effective rate was 83.64%in the observation group,which was higher than that in the control group with 65.45%(P<0.05).The concentrations of Scr and KIM-1,serum IL-6,IL-18 and CRP were(45.21±0.77)μmol/L,(3.20±0.11)μg/L,(0.45±0.13)ng/mL,(0.30±0.12)ng/mL and(0.10±0.03)mg/L in the observation group,which were lower than those in the control group,while the GFR(120.48±1.56)mL/min was significantly higher than that in the control group(P<0.05).The incidence rate of postoperative complication was 1.82%in the observation group,which was significantly lower than that in the control group with 12.73%(P<0.05).There was no significant difference in the incidence rate of adverse reactions which was 5.45% and 3.64% respectively in the two groups(P>0.05).Conclusion Xuebijing injection can obviously improve the renal injury markers and the concentrations of IL-6,IL-18 and CRP,and reduce the postoperative complications without increasing the drugs adverse reactions in the treatment of patients with urinary calculi after MPCNL.Therefore,it is worthy of clinical promotion and application.