贵州医科大学学报

2016, v.41;No.191(08) 963-966

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CRRT对脓毒症急性肾损伤患者肾素活性、血管紧张素Ⅰ及醛固酮水平的影响
Effects of CRRT on RAAS of Patients with Septic Associated AKI

叶声;方丽;王迪芬;唐忠平;
YE Sheng;FANG Li;WANG Difen;TANG Zhongping;Guizhou Medical University;ICU,The First People's Hospital of Guiyang;ICU,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨连续肾脏替代治疗(CRRT)对脓毒症急性肾损伤(AKI)患者肾素、血管紧张素Ⅰ(AngⅠ)及醛固酮(ALD)水平的影响。方法:脓毒症AKI患者30例,随机均分常规组和CRRT组,常规组给予原发病、抗感染及补液等常规治疗,CRRT组在常规治疗基础上给予CRRT治疗;2组患者于治疗前、治疗24 h时,分别检测血清肌酐(SCr)、AngⅠ及ALD水平,计算血浆肾素活性(PRA),比较3组患者急性生理—慢性健康状况Ⅱ(APACHEⅡ)评分。结果:治疗前2组患者PRA、AngⅠ、ALD、SCr及APACHEⅡ评分比较,差异无统计学意义(P>0.05);治疗24 h时,CRRT组PRA、AngⅠ、ALD、SCr及APACHEⅡ评分均显著低于常规组(P<0.05),CRRT组PRA、AngⅠ、ALD、SCr及APACHEⅡ评分低于治疗前(P<0.05);常规组仅SCr、AngⅠ水平及APACHEⅡ评分低于治疗前(P<0.05)。结论:CRRT在常规治疗脓毒症AKI基础上,CRRT可降低患者PRA、AngⅠ、ALD、SCr水平及APACHEⅡ评分。
Objective: To explore the effects of continuous renal replacement therapy( CRRT) on rennin-angiotensin-aldosterone system( RAAS) of patients with septic associated acute kidney injury( AKI). Methods: 30 patients with septic associated AKI were randomly divided into control group and CRRT group. The control group was treated with conventional therapy such as primary disease,anti-infective,and fluid therapy while CRRT group was treated with CRRT besides conventional therapy. The serum levels of creatinine( SCr),aldosterone( ALD) and angiontensin I for the two groups before treatment and 24 h after treatment. The plasma levels of rennin activity( PRA) were calculated. The acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) scores were compared between the two groups. Result: Before treatment there was no statistically significant difference in PRA,AngⅠ,ALD,SCr and scores of APACHE Ⅱ between control group and CRRT group( P > 0. 05).24 h after treatment,PRA,AngⅠ,ALD,SCr and scores of APACHEⅡ in CRRT group were significant lower than their counterparts in control group( P < 0. 05). 24 h after treatment in CRRT group,PRA,AngⅠ,ALD,SCr,scores of APACHE Ⅱwere significantly lower than before treatment( P <0. 05). 24 h after treatment in control group,SCr,Ang Ⅰ,scores of APACHE Ⅱ were significantly lower than before treatment( P < 0. 05),but the other indexes were not significant lower than before treatment( P < 0. 05). Conclusion: CRRT combined with conventional therapy treatment of septic associated AKI can decrease the levels of PRA,AngⅠ,ALD,SCr and APACHEⅡscore.

关键词(KeyWords): 脓毒症;肾素-血管紧张素-醛固酮系统;急性生理-慢性健康状况Ⅱ评分;急性肾损伤;连续肾脏替代治疗
sepsis;renin-angiotensin-aldosterone system;acute physiology and chronic health evaluationⅡ;acute kidney injury;continuous renal replacement therapy

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作者(Author): 叶声;方丽;王迪芬;唐忠平;
YE Sheng;FANG Li;WANG Difen;TANG Zhongping;Guizhou Medical University;ICU,The First People's Hospital of Guiyang;ICU,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.08.024

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