前列腺素E联合连续肾替代治疗脓毒症伴急性肾损伤的临床研究

Abstract
Figure/Table
References (27)
Related Citation (15)

Download: PDF (778 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the clinical effect of Prostaglandin E combined with continuous renal replacement therapy (CRRT) in sepsis with acute kidney injury (AKI). Methods A total of 83 patients with sepsis complicated with AKI who admitted to Hefei Binhu Hospital of Anhui Province from March 2015 to January 2019 were selected and they were divided into the control group (41 cases) and the study group (42 cases) according to the random number table method. The control group was treated with CRRT, and the study group was treated with Prostaglandin E on the basis of the control group. The clinical efficacy, inflammatory factors, kidney function indexes, clinical outcome and adverse reactions were compared between the two groups. Results The total clinical effective rate of the study group was significantly higher than that of the control group after 7 days of treatment (P ＜ 0.05). There was no statistically significant difference in interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) between the two groups before treatment (P ＞ 0.05). Compared with before treatment, Il-6, hs-CRP and TNF-α in the two groups decreased after 7 days of treatment, and the study group was lower than the control group (P ＜ 0.05). There was no significant difference in blood urea nitrogen (BUN), serum creatinine (SCr) and cystatin (CysC) between the two groups before treatment (P ＞ 0.05). Compared with before treatment, BUN, SCr and CysC were all increased in the two groups after 7 days of treatment, but the study group was lower than the control group (P ＜ 0.05). The length of stay in the study group was shorter than that in the control group (P ＜ 0.05), and there was no statistically significant difference in the case fatality rate and the incidence of adverse reactions between the two groups within 28 days (P ＞ 0.05). Conclusion Prostaglandin E combines with CRRT in the treatment of sepsis complicated with AKI has remarkable curative effect. It can effectively alleviate kidney injury, improve the level of inflammatory factors and prognosis, and has good drug safety and high clinical application value.

Key words： Prostaglandin E Continuous renal replacement therapy Sepsis with acute kidney injury Clinical efficacy

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	CHEN Xiaoming1 CHEN Juan2 ZHANG Lin3

Cite this article:

CHEN Xiaoming1 CHEN Juan2 ZHANG Lin3. Clinical study of Prostaglandin E combined with continuous renal replacement in the treatment of sepsis with acute kidney injury[J]. 中国医药导报, 2020, 17(15): 63-66,83.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I15/63

[1] 王方，张媛莉.血管生成素在脓毒症诊断和治疗中的新进展[J].实用医学杂志，2017，33（10）：1707-1709.
[2] 郑文博.糖原合酶激酶-3β对脓毒症及相关急性肾损伤的诊断和预后评估价值研究[J].中国急救医学，2018，38（9）：777-781.
[3] Zhang Y，Shao DR，He ZP，et al. Efficacy of continuous renal replacement on acute renal injury developed in severe sepsis [J]. J Biol Regul Homeost Agents，2019，33（2）：525-530.
[4] 姜启栋，张雪梅，伍长学，等.连续肾替代治疗加用不同剂量血必净对脓毒症合并急性肾损伤患者的影响[J].中国药房，2017，28（8）：1087-1091.
[5] 李淑媛，张莉，刘建，等.不同剂量前列腺素E治疗脓毒症致急性肾损伤的疗效比较[J].中国老年学杂志，2017， 37（24）：6186-6188.
[6] 高戈，冯喆，常志刚，等.2012国际严重脓毒症及脓毒性休克诊疗指南[J].中华危重病急救医学，2013，25（8）：501-505.
[7] 王胜云，陈德昌.降钙素原和C-反应蛋白与脓毒症患者病情严重程度评分的相关性研究及其对预后的评估价值[J].中华危重病急救医学，2015（2）：97-101.
[8] 段绍斌，刘庆，潘鹏，等.RIFLE和AKIN标准在评价住院急性肾损伤患者病死率及其相关危险因素中的应用[J].中南大学学报：医学版，2013，38（12）：1243-1252.
[9] Lipman J，Brett SJ，De Waele JJ，et al. A protocol for a phase 3 multicentre randomised controlled trial of continuous versus intermittent β-lactam antibiotic infusion in critically ill patients with sepsis： BLING Ⅲ [J]. Crit Care Resusc，2019，21（1）：63-68.
[10] Gomez H，Ince C，De Backer D，et al. A unified theory of sepsis-induced acute kidney injury： inflammation，microcirculatory dysfunction，bioenergetics，and the tubular cell adaptation to injury [J]. Shock，2014，41（1）：3-11.
[11] 陈玉红，郑明，李斌，等.不同连续性肾脏替代治疗模式及其剂量对脓毒症合并急性肾损伤患者溶质清除效果的研究[J].中国全科医学，2016，19（18）：2145-2150.
[12] 张莉芬，奚希相，顼志兵，等.中性粒细胞明胶酶相关脂质运载蛋白对脓毒症合并急性肾损伤患者连续性肾脏替代治疗的预测价值[J].中国医药导报，2018，15（34）：85-88.
[13] He F，Zhang C，Huang Q. Long noncoding RNA nuclear enriched abundant transcript 1/miRNA-124 axis correlates with increased disease risk，elevated inflammation，deteriorative disease condition，and predicts decreased survival of sepsis [J]. Medicine （Baltimore），2019，98（32）：e16470.
[14] 房文通.前列腺素E1对损伤血管内皮细胞的保护作用及其机制探讨[D].济南：山东大学，2010.
[15] Zhang Y，Shao DR，He ZP，et al. Efficacy of continuous renal replacement on acute renal injury developed in severe sepsis [J]. J Biol Regul Homeost Agents，2019，33（2）：525-530.
[16] 曹莉，郭阳，刘琳，等.血必净联合前列腺素 E1治疗糖尿病肾病疗效观察[J].现代中西医结合杂志，2016，25（24）：2645-2647，2651.
[17] 郑艳，黄晋，王卫广，等.胸腺肽α1联合血必净注射液对重症肺炎合并脓毒症患者血清CRP、TNF-α、IL-6、IL-8水平的影响[J].中国生化药物杂志，2017，37（3）：165-167.
[18] 邹蕾，黄志远，高燕，等.连续低效每日血液透析滤过联合血液灌流对严重脓毒症患者炎性应激和肾功能及微循环的影响[J].中国医药，2019，14（10）：1543-1547.
[19] 胡秀华，吴英萍，刘彬彬，等.血必净注射液联合持续血液净化在重症脓毒症患者中的应用及对炎症反应水平的影响[J].中国现代医生，2019，57（22）：17-19.
[20] 马兴龙，姜阳，李佳芯，等.脓毒症患者外周血TNF-α、HMGB-1、TF和vWF动态变化及临床意义[J].实用医学杂志，2018，34（4）：630-633.
[21] 曹艳林，刘德贝，夏先考，等.新生儿肺炎合并脓毒症患儿检测血清降钙素原和高敏C反应蛋白的临床价值[J].检验医学，2014，12（10）：1000-1003.
[22] 廉静，张爱菊，张燕.超敏C反应蛋白与扩张型心肌病患者炎症因子水平、心功能的相关性[J].心血管康复医学杂志，2018，27（6）：642-645.
[23] 谢云，吕夷松，董晓亮，等.前列腺素E受体4拮抗剂与透明质酸钠在间质性膀胱炎/膀胱疼痛综合征大鼠模型中的作用比较[J].中华实验外科杂志，2015，32（6）：1236-1239.
[24] 王晓亮，张勇，斯妍娜，等.脂多糖诱导小鼠腹腔巨噬细胞炎性反应中前列腺素E2/前列腺素E受体4调控高迁移率族蛋白Ⅰ的机制[J].中南大学学报：医学版，2017， 42（8）：889-898.
[25] 陈琛，苏华，马琴琴，等.前列腺素E联合连续肾替代治疗对脓毒症合并急性肾损伤预后的影响[J].中国医院药学杂志，2019，39（13）：1386-1389.
[26] 何伟强，夏剑民，黃秋敏，等.持续性血液净化治疗脓毒症急性肾衰竭患者疗效及对毒素清除率的影响分析[J].中国医药科学，2018，8（6）：204-206.
[27] 冯敏，田仁富，邓明强，等.连续性静脉-静脉血液净化对脓毒症患者血流动力学、凝血功能及免疫功能的影响[J].中国医学装备，2018，15（3）：98-102.