摘要
目的探讨前列地尔联合连续性肾脏替代治疗(CRRT)对脓毒症合并急性肾损伤的疗效及血清微小核糖核酸(miR)-155、miR-233水平的影响。方法选取2019年8月至2022年1月在上海市静安区市北医院诊治的108例脓毒症合并急性肾损伤患者为研究对象,依据随机数表法分为对照组和联合组,每组54例。两组患者均接受常规治疗,对照组在常规治疗的基础上接受CRRT治疗,联合组在对照组治疗的基础上使用前列地尔治疗。比较两组患者治疗10 d后的临床疗效及治疗前后的肾血流指标[包括舒张末期流速(EDV)、收缩期峰值流速(PSV)与肾脏动脉阻力指数(RI)]和miR-155、miR-233水平。结果联合组患者的治疗总有效率为90.74%,明显高于对照组的74.07%,差异有统计学意义(P<0.05);治疗前,两组患者的EDV、PSV、RI水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的EDV、PSV水平明显高于治疗前,RI水平明显低于治疗前,且联合组患者的EDV、PSV水平分别为(10.94±3.33)cm/s、(25.47±3.76)cm/s,明显高于对照组的(8.49±3.18)cm/s、(22.32±3.43)cm/s,RI水平为0.53±0.07,明显低于对照组的0.63±0.08,差异均有统计学意义(P<0.05);治疗前,两组患者的miR-155、miR-233水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的miR-155、miR-233水平明显低于治疗前,且联合组患者的miR-155、miR-233水平分别为0.45±0.11、1.66±0.45,明显低于对照组的0.81±0.15、2.25±0.74,差异均有统计学意义(P<0.05)。结论前列地尔联合CRRT应用于脓毒症合并急性肾损伤患者可显著改善临床疗效,且能够有效改善肾血流状况及miR-155,miR-233水平,值得临床推广应用。
Objective To investigate the efficacy of alprostadil combined with continuous renal replacement therapy(CRRT)in the treatment of sepsis complicated with acute kidney injury and its effect on serum microribonucleic acid(miR)-155 and miR-233 levels in patients.Methods A total of 108 patients with sepsis complicated with acute kidney injury who were diagnosed and treated in Shibei Hospital of Shanghai Jing'an District from August 2019 to January 2022 were selected as the research objects.According to the random number table method,they were divided into the control group and the joint group,with 54 cases in each group.Based on conventional treatment,the control group received CRRT,and the joint group was treated with alprostadil on the basis of the control group.After 10 days of treatment,the clinical efficacy and renal blood flow indexes[including end-diastolic velocity(EDV),peak systolic velocity(PSV),and renal arterial resistance index(RI)],miR-155,and miR-233 levels before and after treatment were compared between the two groups.Results The total effective rate of joint group was 90.74%,which was significantly higher than 74.07%of control group(P<0.05).Before treatment,there were no significant differences in EDV,PSV,and RI levels between the two groups(P>0.05);after treatment,the levels of EDV and PSV in the two groups were significantly higher than those before treatment,and the levels of RI were significantly lower than those before treatment;after treatment,the levels of EDV and PSV in the joint group were(10.94±3.33)cm/s and(25.47±3.76)cm/s,which were significantly higher than(8.49±3.18)cm/s,(22.32±3.43)cm/s in the control group,and RI level was 0.53±0.07,which was significantly lower than 0.63±0.08 of the control group;the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in miR-155 and miR-233 levels between the two groups(P>0.05);after treatment,the levels of miR-155 and miR-233 in the two groups were significantly lower than those before trea
作者
梅沁
蒋卫杰
MEI Qin;JIANG Wei-jie(Department of Nephrology,Shibei Hospital of Shanghai Jing'an District,Shanghai 200040,CHINA)
出处
《海南医学》
CAS
2023年第6期774-777,共4页
Hainan Medical Journal
基金
上海市静安区市北医院科研课题(编号:面上2020SBMS07)。
