摘要
目的 探讨体外循环 (CPB)中应用乌司他丁 (UTI)对机体肾脏的影响。方法 择期CPB下心内直视术 40例 (ASAⅡ～Ⅲ级 )分为 2组 :乌司他丁组 (U组 ,n =2 0 ) ,于麻醉后、CPB开始前将UTI 2 0万U溶于 2 0ml 0 9%生理盐水中静脉注射 (约 10min) ;若CPB时间超过 4h ,可在CPB开始 4h后追加 1次 ,剂量方法同前。对照组 (C组 ,n =2 0 )不用UTI。分别于麻醉前及CPB结束 3h后检测血Bun、Cr及尿NAG、RBP、α1-MG、γ -GTP ,统计尿量并计算排尿量 /输液量。结果 麻醉前 :两组病人间血Bun、Cr和尿NAG、RBP、α1-MG、γ -GTP及排尿量均无显著性差异 (P >0 0 5 )。CPB结束后 :⑴两组病人其尿γ -GTP、NAG均分别高于麻醉前( P <0 0 5 ) ,但U组二者均分别低于C组 ( P <0 0 5 )。⑵两组病人其尿RBP、α1-MG均分别明显高于麻醉前 ( P <0 0 1) ,但U组二者分别低于C组 (P <0 0 5 )。⑶两组病人其排尿量均明显多于麻醉前 (P <0 0 1) ,但U组高于C组 (P <0 0 5 )。⑷U组病人其排尿量 /输液量高于C组 (P <0 0 5 )。
Objective To investigate effects of ulinastatin(UTI) on renal function in patients who underwent cardiopulmonary bypass(CPB).Methods Forty cases of ASA grade Ⅱ～Ⅲ undergoing elective open heart surgery under CPB were divided into two groups: group U(n=20) receiving ulinastatin 200,000u in 20ml normal saline by intravenous infusion (about 10min) after general anesthesia and before CPB.Once CPB time more than 4 hours ,another infusion was needed by same dosage .Group C(n=20) receiving no ulinastain.Bun ,Cr, urine-N- acetyl- beta-D- glucosaminidase (u-NAG), urine-γ-GTP, urine-α1 -microglobulin (u-α1-MG),urine retinal binding protein(u-RBP)were measured before anesthesia and after CPB respectively. Volume of urination and ratio of urination volume to transfusion volume were calculated respectively. Results There were no significantly differences in Bun, Cr, u-NAG, u-γ-GTP, u-RBP, u-α1-MG and volume of urination between two groups before anesthesia(P>0 05).After CPB,⑴The levels of u-γ-GTP and u-NAG obviously increased in the two groups respectively(P<0 05) ,and they were obviously lower in group U than that in group C(P<0 05) respectively.⑵The levels of u-RBP and u-α1-MG significantly increased in the two groups respectively (P<0 01) ,and which were obviously lower in group U than that in group C (P<0 05) respectively.⑶The volume of urination significantly increased in the two groups (P<0 01) respectively ,and which was dramatically more in group U than that in group C(P<0 05).⑷The ratio of urination volume to transfusion volume in group U was higher than that in group C(P<0 05).Conclusion Ulinastatin treated patients who undergoing CPB has strong renal protection.
出处
《中国医师杂志》
CAS
2003年第9期1166-1167,共2页
Journal of Chinese Physician
关键词
乌司他丁
体外循环
肾功能
Ulinastatin
Cardiopulmonary,bypass
Renal,function
