内皮素受体拮抗剂治疗肾综合征出血热急性肾衰竭的临床研究

摘要

Objective To evaluate the clinical effect of acute renal failure induced by hemorrhagic fever with sodium ferulate for an endothelin receptor antagonist. Methods 32 acute renal failure induced by hemorrhagic fever patients were divided into the treatment group and control group with 16 cases in each group. The patients in the control group received routine treatment. The treatment group based on routine treatment with sodium ferulate injection. The urea,creatinine in serum, circulating endothelial cells,and urine volume were observed before and after treatment. Results There was no death in the treatment group. But fatality rate in the control group was 6.25%(1/16). No significant difference between the two groups was observed(χ2=1.03,P=0.33). Compared with the control group,the hospitalization time in the treatment group was shortened obviously(t=3.09,P<0.05),cure fate enhanced(χ2=4.57,P=0.033),recovery time of urea and creatinine in serum,estinction time of urinary protein shortened obviously(t respectively amounted to 4.26,4.04,4.32,P<0.05), urine volume increased significantly(t=9.58,P<0.05). The quantity of circulating endothelial cells in the treatment group were significantly lower than the control group(t=5.34,P<0.05). Conclusions Endothelin receptor antagonist combined with routine medication can protect the vascular endothelium cells in patients with acute renal failure induced by hemorrhagic fever, which helps the recovery of patients.%　　目的探讨内皮素受体拮抗剂阿魏酸钠治疗肾综合征出血热(HFRS)急性肾衰竭的临床疗效.方法将32例肾综合征出血热急性肾衰竭患者按抽签方式随机分为治疗组和对照组,各16例.对照组给予常规药物治疗,治疗组在对照组治疗基础上应用内皮素受体拮抗剂阿魏酸钠注射液,密切观察治疗前后血清尿素氮(BUN)、血清肌酐(Scr)、循环内皮细胞水平和尿量的变化.结果治疗组无死亡病例,对照组病死率为6.25%(1/16),两组比较差异无统计学意义(χ2=1.03,P=0.33).但与对照组比较,治疗组患者住院时间明显缩短(t=3.09,P<0.05),治愈率显著提高(χ2=4.57,P=0.033),血清BUN、Scr恢复时间和尿蛋白消失时间也明显缩短(t值分别为4.26,4.04,4.32,均P<0.05),尿量显著增加(t=9.58,P<0.05).治疗组循环内皮细胞水平也显著低于对照组(t=5.34,P<0.05).结论内皮素受体拮抗剂配合常规药物治疗可保护肾综合征出血热急性肾衰竭患者血管内皮,有助于患者康复.