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目的:探讨休克患者采用曲美他嗪辅助常规抗休克治疗对肾功能的保护作用。方法:将2012-03-2014-03我院重症监护病房收治的62例因各种原因引起休克的患者采用随机数字表法分为研究组和对照组,各31例。2组均采用常规的抗休克治疗方案,研究组患者加用曲美他嗪(20mg口服,3次/d),比较2组患者治疗前后不同时间的肾功能指标及相关血流动力学指标的变化情况。结果:研究组和对照组治疗后48h、第7天的尿量较本组治疗前显著升高,血肌酐(SCr)、尿素氮(BUN)、血清胱抑素C(CysC)、血乳酸(LAC)、尿素-谷氨酸转肽酶(γ-GTP)值较治疗前显著降低(P<0.05);治疗后第7天研究组的SCr、BUN、CysC、LAC、γ-GTP值较对照组显著降低(P<0.05)。研究组和对照组治疗后48h的平均动脉压(MAP)、中心静脉血氧饱和度(ScvO_2)值较治疗前显著提高(P<0.05),心率(HR)较治疗前显著降低(P<0.05);2组的丙二醛(MDA)值在治疗后48h、第7天较治疗前显著降低,血超氧化物歧化酶(SOD)较治疗前显著升高(P<0.05);治疗后第7天研究组患者的SOD、MDA值显著优于对照组(P<0.05)。结论:常规抗休克治疗辅以曲美他嗪能够进一步改善休克患者的肾功能。
Objective: To investigate the protective effects of trimetazidine on renal function in patients with shock assisted by conventional anti-shock therapy. Methods: Sixty-two patients admitted to intensive care unit in our hospital from March 2012 to March 2014 were randomly divided into study group (n = 31) and control group (n = 31). The two groups were treated with conventional anti-shock therapy. Patients in the study group were treated with trimetazidine (20 mg orally, 3 times daily), and the renal function and hemodynamics were compared between the two groups before and after treatment Changes. Results: The urine volume of the study group and the control group on the 7th day after treatment was significantly higher than that of the control group on 48th day after treatment. The levels of serum creatinine, BUN, CysC, LAC and γ-GTP were significantly lower than those before treatment (P <0.05). On the 7th day after treatment, the SCr, BUN, CysC, LAC and γ-GTP in the study group were significantly higher than those in the control group Group was significantly lower (P <0.05). The mean arterial pressure (MAP) and central venous oxygen saturation (ScvO_2) in study group and control group increased significantly (P <0.05) and heart rate (HR) decreased 48 h after treatment ); The malondialdehyde (MDA) in group 2 decreased significantly at 48h and 7d after treatment than that before treatment, and the level of serum superoxide dismutase (SOD) increased significantly (P <0.05) The 7-day study group patients with SOD, MDA value was significantly better than the control group (P <0.05). Conclusion: Conventional anti-shock treatment combined with trimetazidine can further improve renal function in patients with shock.