美罗培南联合常规治疗对脓毒症休克合并急性肾功能不全患者炎性因子、肾功能及免疫球蛋白的影响

摘要 目的：探讨脓毒症休克合并急性肾功能不全患者在常规治疗的基础上联合美罗培南治疗后对其肾功能、炎性因子及免疫球蛋白的影响。方法：选取我院80例脓毒症休克合并急性肾功能不全患者，根据随机数字表法分为对照组（n=40）和研究组（n=40），对照组予以常规治疗，研究组在对照组的基础上联合美罗培南治疗，比较两组患者疗效、炎性因子[降钙素原（PCT）、C反应蛋白（CRP）、白介素-6（IL-6）]、肾功能[尿素氮（BUN）和血肌酐（Scr）]、免疫球蛋白[免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、免疫球蛋白A（IgA）]及不良反应。结果：研究组治疗1个疗程后的临床总有效率为90.00%（36/40），高于对照组的72.50%（29/40）（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。两组患者治疗1个疗程后BUN、Scr和PCT、CRP、IL-6均下降，且研究组低于对照组（P<0.05）。两组患者治疗1个疗程后IgG、IgM均升高，且研究组高于对照组（P<0.05）；两组患者治疗1个疗程后IgA组间及组内比较无差异（P>0.05）。结论：脓毒症休克合并急性肾功能不全患者在常规治疗的基础上联合美罗培南治疗，疗效显著，可有效改善肾功能及免疫功能，减轻炎性反应，且安全性较好。

Effects of Meropenem Combined with Routine Treatment on Inflammatory Factors, Renal Function and Immunoglobulin in Septic Shock Patients with Acute Renal Insufficiency

ABSTRACT Objective: To investigate the effect of meropenem combined with routine treatment on inflammatory factors, renal function and immunoglobulin in septic shock patients with acute renal insufficiency. Methods: 80 patients with septic shock with acute renal insufficiency were selected, they were divided into control group (n=40) and study group (n=40) according to the random number table. The control group was treated with routine treatment. The study group was treated with meropenem on the basis of the control group. The efficacy, inflammatory factors [procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), renal function [urea nitrogen (BUN), blood creatinine (Scr)], immunoglobulin [immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IGA)], and adverse reactions were compared. Results: The total effective rate of the study group 1 course after treatment was 90.00% (36/40), which was higher than 72.50% (29/40) of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 1 course after treatment, BUN, SCR and PCT, CRP, IL-6 decreased of both groups, and the study group was lower than the control group (P<0.05). 1 course after treatment, the IgG and IgM of the two groups increased, and the study group was higher than the control group (P<0.05). There was no significant difference between the two groups in the IgA group and within the group (P>0.05). Conclusion: Meropenem combined with routine treatment is effective in the treatment of septic shock combined with acute renal insufficiency. It can effectively improve renal function and immune function, reduce inflammatory response, and which has good safety.