前列地尔联合连续性肾脏替代治疗在老年糖尿病肾病合并急性肾损伤患者中的临床观察

Clinical observation of alprostadil combined with continuous renal replacement therapy in treatment of diabetic kidney disease complicated with acute kidney injury in elderly patients

中文关键词: 老年  糖尿病肾病  急性肾损伤  前列地尔  连续性肾脏替代治疗

英文关键词: elderly  diabetes kidney disease  acute kidney injury  alprostadil  continuous renal replacement therapy

中文摘要:

      目的 观察前列地尔联合连续性肾脏替代治疗(CRRT)在老年糖尿病肾病(DKD)合并急性肾损伤(AKI)患者中的疗效.方法 回顾性选取2022年3月—2024年5月在江苏省苏北人民医院确诊的118例老年DKD合并AKI患者,根据不同治疗方案分为观察组(前列地尔联合CRRT治疗,n=56)和对照组(CRRT治疗,n=62).观察并比较2组患者治疗前后血指标值[血糖、Scr、尿素氮(BUN)水平]、尿液指标值[24 h尿蛋白、尿NGAL水平、尿沉渣评分、24 h尿白蛋白排泄率(UAER)];比较2组临床疗效和治疗不良反应.结果 治疗后,观察组血糖[(10.9±1.5)vs(13.1±2.9)mmol/L]、Scr[(231.7±43.5)vs(376.5±51.0)μmol/L]、BUN[(12.6±2.9)vs(14.8±3.3)mmol/L]、24 h 尿蛋白[(1.8±0.8)vs(2.3±1.3)g/L]、尿 NGAL[(54.9±16.3)vs(62.3±14.6)mg/L]及尿沉渣评分[1(0,1)vs 1(0,2)]均低于对照组(均P＜0.05).观察组治疗总有效率高于对照组(92.9％vs 74.4％,P＜0.05).2组不良反应发生率差异无统计学意义(P＞0.05).结论 前列地尔联合CRRT可能改善老年DKD合并AKI患者的临床结局,改善糖代谢状态,保护肾脏功能.

英文摘要:

      Objective To observe the efficacy of alprostadil combined with continuous renal replacement therapy(CRRT)in the treatment of elderly patients with diabetic kidney disease(DKD)complicated with acute kidney injury(AKI).Methods A retrospective study included 118 elderly patients diagnosed with DKD and AKI diagnosed in Subei People's Hospi-tal from March 2022 to May 2024.According to different treatment methods,they were divided into control group(CRRT,n=62)and observation group(alprostadil combined with CRRT,n=56).The serum indexes[blood glucose,serum creati-nine(Scr),blood urea nitrogen(BUN)]and urine indexes[24 h urinary protein,urinary neutrophil gelatinase-associated li-pocalin(NGAL),urinary sediment score,24 h urinary albumin excretion rate(UAER)]before and after treatment,as well as the clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the levels of blood glucose[(10.9±1.5)vs(13.1±2.9)mmol/L],Scr[(231.7±43.5)vs(376.5±51.0)μmol/L],BUN[(12.6±2.9)vs(14.8±3.3)mmol/L)],24 h urinary protein[(1.8±0.8)vs(2.3±1.3)g/L],urinary NGAL[(54.9±16.3)vs(62.3±14.6)mg/L]and urinary sediment score[1(0,1)vs 1(0,2)]in the observation group were significantly lower than those in the control group(all P＜0.05).The total effective rate in the observation group was signifi-cantly higher than that in the control group(92.9％vs 74.4％,P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The combination of alprostadil and CRRT may improve the clinical outcomes of elderly patients with DKD and AKI,improve glucose metabolism status,and protect kidney function.