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急性肾功能障碍是心脏外科手术后常见的并发症,主要原因是术前的高血清肌酸激酶浓度、高龄以及术后血流动力学不稳定。传统上使用利尿剂增加肾血流量,从而减少肾损害的发生,近年研究发现其并不能改善肾愈后小剂量的多巴胺可使肾血管扩张,增加肾血流量。同时,多巴胺抑制肾小管的重吸收,但并不能改善肾功能和防止一过性肾损伤。有研究发现静注心钠素(ANP)可改善肾功能,防止细胞损伤。对于急性肾功能障碍.快速输注ANP有利于稳定血流动力学,提高肾小球滤过率。本实验旨在明确长时程(>48 h)输注ANP(50 mg·kg-1·min 1)的临床效果。
Acute renal dysfunction is a common complication after cardiac surgery, mainly due to preoperative serum creatine kinase concentration, advanced age, and postoperative hemodynamic instability. Traditionally use of diuretics to increase renal blood flow, thereby reducing the incidence of renal damage, recent studies found that it does not improve the kidney after a small dose of dopamine can make renal vasodilatation and increase renal blood flow. At the same time, dopamine inhibits renal tubular reabsorption but does not improve renal function and prevent transient kidney damage. Some studies have found that intravenous injection of atrial natriuretic peptide (ANP) can improve renal function and prevent cell damage. For acute renal dysfunction, rapid infusion of ANP is beneficial for stabilizing hemodynamics and increasing glomerular filtration rate. The purpose of this experiment was to identify the clinical effects of long-term (> 48 h) infusion of ANP (50 mg · kg-1 · min 1).