Abstract：【Objective】 To investigate the clinical curative effect of ulinastatin combined with continuous renal replacement therapy (CRRT) in the treatment of type I acute cardiorenal syndrome (ACRS). 【Methods】 A total of 120 patients with ACRS were divided into two groups by the random method, with 60 cases in each group. Patients in the control group were given CRRT while patients in the observation group were treated with ulinastatin for 3 consecutive days in addition to CRRT. The renal and cardiac function were evaluated between the two groups after 14 days of treatment. The levels of plasma creatinine (Scr) and NT-proBNP were detected. The Ccr and GFR were calculated. The LVEF was diagnosed. 【Results】 The survival rate of the observation group was 83.33% (50/60), which was slightly higher than that of the control group 71.66% (43/60). The recovery rate of renal function and the rate of grade Ⅱ to Ⅲ of the heart function after treatment in the observation group were 45.0% (27/60) and 25.0% (15/60), respectively, which were slightly higher than those in the control group, which were 31.67% (19/60), and 15.0% (9/60), respectively. However, those differences were not statistically significant (P>0.05). After treatment, LVEF (left ventricular ejection fraction), Ccr (endogenous creatinine clearance) and GFR (glomerular filtration rate) were higher in the observation group than those in the control group, while levels of NT-proBNP (plasma N-terminal B-type natriuretic peptide precursor) and Scr (creatinine) were lower than in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】 The application of ulinastatin combined with CRRT in the treatment of ACRS can protect cardiac and renal function, but the improvement of short-term prognosis is not obvious.
王晶, 冯丽荣. 乌司他丁联合CRRT治疗Ⅰ型急性心肾综合征的疗效[J]. 医学临床研究, 2018, 35(5): 900-902.
WANG Jing, FENG Li-rong. Ulinastatin Combined with Continuous Renal Replacement Therapy in the Treatment of Type I Acute Cardiorenal Syndrome. JOURNAL OF CLINICAL RESEARCH, 2018, 35(5): 900-902.
[1] Prins KW, Wille KM, Tallaj JA, et al. Assessing continuous renal replacement therapy as a rescue strategy in cardiorenal syndrome 1.[J]. Ndt Plus, 2015,8(1):87-92. [2] 赵丽娜,闫海冰,牛科超,等.乌司他丁联合连续血液净化对严重脓毒症患者心肌损伤的保护作用[J].医学临床研究,2016,33(4):644-646,649. [3] 中华医学会心血管病分会,中华心血管疾病杂志编辑委员会.急性心力衰竭诊断治疗指南[J].中国心血管病杂志,2010,35(3):195-208. [4] Wall BM. Cardiorenal risk factors[J]. Am J Med Sci, 2010, 340(1):25-29. [5] Ronco C, House AA, Haapio M. Cardiorenal syndrome: refining the definition of a complex symbiosis gone wrong[J]. Intensive Care Med, 2008,34(5):957-962. [6] Iwagami M, Yasunaga H, Noiri E, et al. Current state of continuous renal replacement therapy for acute kidney injury in Japanese intensive care units in 2011: analysis of a national administrative database[J]. Nephrol Dial Transplant, 2015,30(6):988. [7] 生杰,王媛,刘春艳,等.4种血液净化方式治疗老年Ⅰ型心肾综合征的疗效评估[J].中国全科医学,2015,18(22):2671-2675. [8] 严文艳.连续性肾脏替代治疗1型心肾综合征患者的预后及影响因素[J].肾脏病与透析肾移植杂志,2016,25(3):214-219.
2018, Vol. 35 
