余兰

【摘要】 目的：探讨前列地尔联合黄芪治疗重度全身性感染伴急性肾损伤的效果。方法：选取2012年

6月-2017年6月医院收治的重度全身性感染伴急性肾损伤患者120例，根据治疗方式分为研究组和对照组，各60例。对照组采用常规治疗，研究组在对照组基础上加用前列地尔联合黄芪治疗，疗程均为2周。比较两组治疗前后器官功能衰竭评分（SOFA）、急性生理与慢性健康评分（APACHEⅡ）以及急性炎症指标。结果：治疗后，两组SOFA评分和APACHEⅡ评分均低于治疗前（P<0.05），且研究组治疗后SOFA评分和APACHEⅡ评分均明显低于对照组（P<0.05）。两组治疗后PCT、CRP、TNF-α和IL-6水平均明显低于治疗前（P<0.05），且研究组治疗后PCT、CRP、TNF-α、IL-6水平均明显低于对照组（P<0.05）。结论：前列地尔联合黄芪对重度全身性感染患者急性肾损伤治疗效果较好，可有效改善患者临床评分，降低炎症介质水平，临床疗效优于单纯基础治疗方案。

【关键词】 前列地尔; 黄芪; 急性肾损伤

【Abstract】 Objective：To investigate the effect of Alprostadil combined with Astragalus on clinical outcomes in patients with severe systemic infection with acute kidney injury.Method：120 patients with severe systemic infection and acute kidney injury admitted to hospital from June 2012 to June 2017 were selected and divided into study group and control groups，60 cases in each groups.The control group was treated with conventional therapy.The study group was treated with Alprostadil combined with Astragalus on the basis of the control group，the course of treatment was 2 weeks.The infection-related organ failure score（SOFA），acute physiology and chronic health score（APACHEⅡ）and acute inflammation indicators in two groups were compared before and after treatment.Result：The SOFA score and APACHE Ⅱ score of two groups after treatment were lower than those before treatment（P<0.05）.The SOFA score and APACHEⅡ score after treatment in the study group were significantly lower than those in control group（P<0.05）.The levels of PCT，CRP，TNF-α and IL-6 in the two groups were significantly lower than those before treatment（P<0.05）.The levels of PCT，CRP，TNF-α and IL-6 in the study group after treatment were significantly lower than those of the control group（P<0.05）.Conclusion：Alprostadil combined with Astragalus is effective in the treatment of acute kidney injury in patients with severe systemic infection，it can effectively improve the clinical score and reduce the level of inflammatory mediators，the clinical efficacy is better than the simple basic treatment.

【Key words】 Alprostadil; Astragalus; Acute kidney injury

First-authors address：Chengdu University of Technology，Chengdu 610059，China

doi：10.3969/j.issn.1674-4985.2019.17.004

全身性感染是指全身炎癥反应失调综合征，临床中常见。由感染导致重症病例，出现多器官功能衰竭，进展为急性肾功能衰竭致死，是肾病患者不良预后的危险因素[1]。目前临床尚缺少明确针对性改善预后的措施，只能采用对症治疗和支持治疗，重症全身性感染患者死亡未呈现下降趋势，如何改善全身性感染肾脏损伤疗效，成为新的探索方向[2]。采取有效的措施来清除机体炎性介质，降低炎性反应，对改善肾功能和预后十分关键。黄芪有利水消肿、托毒排脓、益气升阳、健脾利湿、固表益卫、生肌等功效。黄芪组分包含黄酮、多糖、多种皂苷，以及蒽醌类、生物碱、氨基酸、亚油酸和金属元素等成分，有利尿、免疫调节、降低蛋白尿、抗氧化、衰老、炎症和肿瘤、降压降糖降脂、保护心脏等疗效[3]。黄芪治疗肾脏疾病已在传统医学的实践中广泛应用。黄芪可以起到调节免疫功能、抗炎、抗过敏等多种药理作用，具有治疗价值。……