乌司他丁对脓毒症急性肾损伤患者心钠肽、尿肾损伤分子-1以及血清半胱氨酸蛋白酶抑制剂的影响

Impact of Ulinastatin on ANP, CYS and KIM-1 in sepsis patients with acute kidney injury

摘要:

目的  探讨乌司他丁对脓毒症急性肾损伤（AKI）患者心钠肽（ANP）、尿肾损伤分子-1（KIM-1）以及血清半胱氨酸蛋白酶抑制剂（CYS）的影响。方法  将患者随机分为对照组和观察组，对照组患者在入院后及时进行抗感染、重症监护、呼吸辅助及营养支持等常规治疗；观察组患者采用常规治疗基础上联合乌司他丁治疗，两组患者均进行1个疗程的治疗；检测患者尿液样本中ANP和KIM-1含量及血液样本中CYS含量，并对患者治疗前后急性生理与慢性健康评分进行评估分析。结果  对照组患者尿液样本中ANP水平逐渐增加，而观察组则于治疗第3天时达到峰值之后逐渐下降，且在治疗3 d后两组间差异具有统计学意义（t =2.91及8.59，P <0.05）；对照组患者尿液样本中KIM-1及血液样本中CYS水平逐渐递增，而观察组则于治疗第5天时达到峰值之后逐渐下降，在治疗第7天时两组间差异具有统计学意义（t =11.23及35.89，P <0.05）；此外，两组组内及组间不同时间点比较，其尿液样本中ANP、KIM-1及血液样本中CYC水平均存在显著性差异（F = 7.32、10.16、5.89及19.74、21.05、11.63，P <0.05）；治疗前后两组患者APACHEⅡ存在显著性差异（t =16.04及35.49，P <0.05），且治疗后两组间亦存在显著性差异（t =18.80，P <0.05），但治疗前两组间差异无统计学意义（t =0.71，P >0.05）。结论  乌司他丁能够显著降低脓毒症急性肾损伤患者体内ANP、KIM-1以及CYS水平，对肾损伤具有一定的保护作用。

Abstract:

Objective To study the impact of Ulinastatin on ANP, CYS, KIM-1 in sepsis patients with acute kidney injury (AKI). Methods The patients were randomly divided into control group and observation group, control group patients in a timely manner after admission anti-infection, intensive care, breathe, and nutritional support and other conventional treatment; Observation group of patients in the conventional treatment combined Ulinastatin treatment, two groups of patients were treated for a period of treatment; Detection of patients with ANP and KIM-1 content in urine samples, blood samples CYS content and the before and after treatment in patients with acute physiology and chronic health evaluation assessment analysis. Results Control group gradually increased in ANP levels in the urine samples while the observation group in the treatment of the third day after the peak gradually decline, and in the treatment of three days later the statistically significant difference between the two groups (t = 2.91 and 8.59, P < 0.05); Control group the KIM-1 and CYS levels increases gradually and the observation group in treatment 5 days after the peak gradually decline, and in the treatment of seven days statistically significant difference between the two groups (t = 11.23 and 35.89, P < 0.05); In addition, Different time points within two way and different time points between groups compare the ANP, KIM-1 and CYS level are significant differences (F = 7.32, 10.16, 5.89 and 19.74, 21.0, 11.63, P < 0.05); Before and after treatment between two groups of patients with APACHEⅡ there were significant differences (t = 16.04 and 35.49, P < 0.05) and also exist significant differences between the two groups after treatment (t = 18.80, P < 0.05), but treatment there was no statistically significant difference between the two groups (t = 0.71, P > 0.05). Conclusions Ulinastatin on sepsis patients with AKI in ANP, KIM-1 and CYS levelhas certain protective effect on renal injury.