低分子肝素对脓毒症急性肾损伤患者的疗效评价.pdf

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1、中国当代医药2014年9月第21卷第25期·药物与临床·低分子肝素对脓毒症急性肾损伤患者的疗效评价潘毅何飞民孙贵才夏芝辉韩飚闫智杰南昌大学第四附属医院重症医学科。南昌330003【摘要】目的观察低分子肝素对脓毒症患者急性肾损伤的疗效及预后的影响。方法选取30例脓毒症合并肾损伤的患者，随机分为治疗组和对照组，对照组常规给予抗感染、呼吸支持、营养支持等治疗，治疗组给予低分子肝素针皮下注射，观察患者治疗后第3、7天肾功能胱抑素C(CysC)、血清肌酐(SCr)等的变化情况．并统计28d生存率。结果治疗组患者治疗后第3、7天

2、CysC水平与对照组比较，差异有统计学意义(P<0．01)；SCr治疗后第3天与对照组比较，差异无统计学意义(P>0．05)，第7天与对照组比较，差异有统计学意义(P<0．05)；两组急性生理及慢性健康评分lI(APACHEII评分)比较，差异无统计学意义(P>0．05)；治疗组生存11例，对照组生存9例：两组生存患者的CysC差异无统计学意义，而对照组死亡患者的CysC明显高于治疗组(P<0．05)。结论低分子肝素治疗脓毒症急性肾损伤，可减轻脓毒症肾损伤程度，改善肾功能，并在一定程度上影响预后。【关键词】脓毒症；肾

3、损伤；低分子肝素【中图分类号】R692[文献标识码】A【文章编号】1674—4721(2014)09(a)一0069—03CurativeefectevaluationonlowmolecularheparininsepsispatientswithacutekidneyinjuryPANYiHEfei——minSUNGui--caiXIAZhi——huiHANBiaorANZhi~ieIntensiveCareUnit，theFourthAffiliatedHospitalofNanchangUniversity，

4、Nanchang330003，China[Abstract]ObjectiveToobservetheeffectandprognosticimpactoflowmolecularheparininsepsispatientswitha—cutekidneyinjury．Methods30casesofsepsispatientswithcombinedrenalinjurywereselectedandrandomlydivid—edintotreatmentgroupandcontrolgroup，thecont

5、rolgroupwasgivenroutineanti—infection，respiratorysupport，andnu—tritionalsupporttreatment，thetreatmentgroupwasgivenlowmolecularheparinsubcutaneousinjectionneedle，thechangeofrenalfunctioncystatinC(CysC)，serumcreatinine(SCr)SOonin3and7daysaftertreatmentwereobserve

6、d，thesurvivalrateof28dayswerecounted．ResultsTheCysClevelinin3and7daysaftertreatmentoftreatmentgroupcomparedwiththecontrolgroup，thedifferencewasstatisticallysignificant(Pl<0．01)，buttheSCrin3daysaftertreat-mentcomparedwiththecontrolgroup，therewasnostatisticallysi

7、gnificantdifference(0．05)，the3daysaftertreatmentcomparedwiththecontrolgroup，thedifferencewasstatisticallysignificant(P<0．05)．Theacutephysiologyandchronichealthevaluation11(APACHElIscore)betweenthetwogroups，therewasnostatisticallysignificantdifference0．05)．Thetr

8、eatmentgroupsurvivalin11cases，9casesincontrolgroup，theCysCinsurvivalpatientsoftwogroupswithnostatisticalsignificance，whiletheCysCindeathpatientsofcontrolgroupwassignificantl