前列地尔脂微球载体制剂治疗心肾综合征临床观察

摘要

Objective To investigate the effect of on the basis of conventional therapy with alprostadil lipo preparations on the cardio-renal syndrome patients. Methods 68 cases of cardio-renal syndrome were randomly divided into treatment group ( 36 cases ) and control group ( 32 cases ). Control group using conventional drug therapy, the treatment group using conventional therapy and alprostadil lipo preparations 10 |xg, once daily, continuous application of 15 d. These two groups were compared before and after treatment in plasma serum creatinine( Scr ),blood urea nitrogen ( BUN ), and endogenous creatinine clearance rate ( Ccr ), serum B type brain natriuretic peptide ( BNP ) level. Left ventricular ejection fraction ( LVEF ), renal artery and its branches ( inter-lobar arteries ) peak systolic velocity( PSV ), resistance index( RI ) and pulsatility index( PI ) changes were also observed. Results Scr, BUN, BNP levels in treatment group were significantly reduced than in the control group, while Ccr levels was elevated ( P <0.05 ). LVEF^PSV were increased than those of the control group ( P <0.05 ), while the kidneys of the main renal artery, segmental arteries, inter-lobar arterial blood flow distribution is significantly improved ( P < 0.05 ). Conclusion Alprostadil could further improve the heart and kidney function in cardio-renal syndrome patients.%目的 观察在常规治疗基础上加用前列地尔脂微球载体制剂,对心肾综合征患者心肾功能的改善作用.方法 将68例心肾综合征患者随机分为治疗组(36 例)和对照组 (32例).对照组采用常规药物治疗,治疗组在此基础上加用前列地尔脂微球载体制剂10 μg静脉滴注,每日 1 次,连续应用 15 d.比较2组治疗前后血肌酐(Scr)、尿素氮(BUN)、内生肌酐清除率(Ccr)及血清B型脑钠肽(BNP)的水平;观察左室射血分数(LVEF)、肾动脉及其分支(叶间动脉)的收缩期峰值血流速度(PSV)、阻力指数(RI)和搏动指数(PI)的变化.结果 与治疗前比较,2组患者血浆Scr、BUN、BNP水平显著降低,Ccr水平升高(P＜0.05),且治疗组优于对照组(P<0.05).LVEF、PSV均较治疗前提高(P＜0.05),RI、PI较治疗前降低(P<0.05),且治疗组较对照组改善更显著(P<0.05).结论 常规治疗基础上加用前列地尔脂微球载体制剂可进一步提高心肾综合征患者的心肾功能.