VCTDSA联合CT 灌乌司他丁联合硝苯地平控释片对ESWL 术后肾功能的保护作用

目的：观察乌司他丁(商品名天普洛安)和硝苯地平控释片(商品名拜新同)对体外冲击波碎石术(ESWL)所致急性肾功能损害 的保护作用。方法：将80 例接受ESWL治疗的肾结石患者，随机分为天普洛安组、拜新同组、天普洛安和拜新同联合组以及对照 组，每组20 例。检测并比较ESWL 前1 d 和后1、3、5 d 患者尿丙二醛(MDA)、N- 乙酰-beta-D- 氨基葡萄糖苷酶/ 肌酐(NAG/Cr)和 24 h尿beta2-微球蛋白(beta2-MG)的变化。结果：EWSL术后第1 天，对照组MDA、NAG/Cr和茁2-MG 水平均明显高于术前(P＜0.05)， 且随着术后时间的延长，患者MDA、NAG/Cr 和beta2-MG 水平呈逐渐下降趋势，术后第1、3、5 天治疗组MDA、NAG/Cr 和beta2-MG 数值均明显低于相同时点对照组(P＜0. 05)。术后第1、3 天，联合用药组MDA、NAG/Cr和beta2-MG 水平明显低于单独用药的两组 (乌司他丁组和拜新同组)(P＜0.05)，第5 天联合用药组MDA、NAG/Cr 和beta2-MG 水平与单独用药的两组(乌司他丁组和拜新同 组)比较均无明显差异(P＞0.05)，单独用药的两组(乌司他丁组和拜新同组)之间在相同时点MDA、NAG/Cr 和beta2-MG 水平无明显 差异。结论：乌司他丁可显著减轻ESWL所致的肾损伤，与钙离子拮抗剂联合用药效果更佳。

Study on the Protective Effect of Ulinastatin Combined with Nifedipine Controlled Release Tablets on the Renal Function after the ESWL

Objective:Studying on the protective effect of Ulinastatin combined with Nifedipine Controlled Release Tablets on the renal function after the ESWL.Methods:80 patients accepted ESWL treatment were randomly divided into Ulinastatin group, Nifedipine group, combined group and control group, with 20 patients in each group. We measured the MDA and NAG/Cr at One day before the operation and the first day, third day, the fifth day after the operation , also measured the beta2-MG during the postoperative 24 hours.Results:On the first day after ESML, the MDA, NAG/Cr and beta2-MG levels of control group were significantly higher than those pre-operation (P<0.05), and presented downtrend with the increase of time, the MDA, NAG/Cr and beta2-MG levels of treatment groups on the first day, third day and fifth day after operation were significantly lower than those of the control group (P<0.05). On the first day and the third day after operation, the MDA, NAG/Cr and beta2-MG levels of combined group were significantly lower than the other treatment group(Ulinastain group and Nifedipine group)(P<0.05), which showed no significant difference on the fifth day after operation. The separate groups (Ulinastain group and Nifedipine group) showed no significant difference at the same time.Conclusion:Ulinastatin had the function of eliminate free radicals and relieve peroxide of lipid, which could lighten the kidney damage and the efficacy of ulinastatincombined with Calciumantagonists was better.