【摘要】 目的探讨促红细胞生成素(EPO)在老年患者医院获得性急性肾损伤(HA-AKI)防治中的作用。方法将广东省佛山市顺德区桂洲医院2013年5月~2014年5月住院的老年HA-AKI患者80例随机分成治疗组40例和对照组40例。对照组给予停用肾毒性药物、解除梗阻、补充血容量、抗感染及纠正酸中毒、防治电解质紊乱、营养支持等,对符合血液净化指征的给予血液透析治疗。治疗组在对照组的基础上,接受r Hu-EPO 50 U/kg隔日1次,皮下注射治疗,连续12周。观察患者治疗前后血压[收缩压(SBP)、舒张压(DBP)]、尿量、血红蛋白(Hb)、血肌酐(SCr)、尿素氮(BUN)、血钾(K+)、肾小球滤过率(e GFR)[慢性肾脏病流行病学合作研究公式(CKD-EPI)]、住院日、住院费用、病死率。采用SPSS 18.0统计软件进行统计分析。结果与治疗前比较,两组治疗后SBP、DBP均显著降低,尿量明显增加,差异有统计学意义(P<0.05)。两组患者治疗后贫血均得到不同程度的纠正,但对照组治疗前后比较差异无统计学意义(P>0.05);而治疗组治疗后Hb明显上升,差异有高度统计学意义(P<0.01);组间比较,差异亦有统计学意义(P<0.05)。两组治疗后SCr、BUN、e GFR、K+水平较治疗前明显好转,差异有统计学意义(P<0.05);两组治疗后SCr、BUN、e GFR水平比较,差异亦有统计学意义(P<0.05)。治疗组比对照组住院时间明显缩短,住院费用明显降低,病死率明显降低,差异均有统计学意义(P<0.05)。结论采用EPO对老年患者HA-AKI进行干预,能够促进老年HA-AKI患者肾脏损伤的修复,保护其肾功能,缩短住院时间和减少住院费用,降低其病死率,且副作用少,值得临床推广。更多还原

【Abstract】 Objective To explore the significance of erythropoietin(EPO) on elderly patients with hospital acquired acute kidney injury(HA-AKI). Methods 80 hospitalized elderly patients with HA-AKI in Guizhou Hospital of Shunde District in Foshan City from May 2013 to May 2014 were divided into 40 cases in treatment group and 40 cases in control group randomly. Control group was stopped given of synchronicity drugs, removed obstruction, supplemented the blood volume, given infection treatment, corrected acidosis, prevented and controlled of electrolyte disturbances, given nutritional support, etc., those who were met with the indications of blood purification were given of blood dialysis treatment. The control group was accepted extra r Hu-EPO 50 U/kg, one time every other day, subcutaneous injection treatment during 12 consecutive weeks. The blood pressure(SBP, DBP), urine output, hemoglobin(Hb), serum creatinine(SCr), urea nitrogen(BUN), potassium(K+) and glomerular filtration rate(e GFR)(chronic kidney disease epidemiology collaboration equation, CKD-EPI), hospitalization days, hospitalization expenses and mortality were observed before and after treatment in both groups. SPSS 18.0 statistical software was used for statistical analysis. Results Compared with before treatment, the level of SBP, DBP after treatment in the two groups was decreased, and urine volume was increased, the differences were statistically significant(P < 0.05). Anemia of patients in both groups after treatment were corrected to varying degrees, but there was no statistically significant difference before and after treatment in the control group(P > 0.05); and Hb was significantly increased in the treatment group, the difference was statistically significant(P < 0.01); there was statistically significant difference between the two groups(P < 0.05). The levels of SCr,BUN, e GFR, K were improved significantly after treatment, the differences were statistically significant(P < 0.05); SCr,BUN, e GFR between the two groups were statistically significant different(P < 0.05). The hospitalization time was shorten, hospitalization costs were significantly reduced, the mortality was significantly lower in treatment group, the differences were statistically significant between the two groups(P < 0.05). Conclusion The using of EPO plays an important role in promoting the repair of kidney damage, protecting the renal function, shortening hospitalization time and reducing hospitalization expenses, reducing the mortality rate, and lessening side effects in elderly patients with HA-AKI to intervene, which is worthy of clinical promotion.更多还原