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1d和后1、3、5d患者尿丙二醛（MDA）、N-乙酰-β-1）．氨基葡萄糖苷酶／肌酐（NAG／Cr）和24h尿B2-微球蛋白（p2-MG）的变化。结果：EWSL术后第1天，对照组MDA、NAG／Cr和β2-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β2-MG水平呈逐渐下降趋势，术后第1、3、5天治疗组MDA、NAG／Cr和132．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32-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β2-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N组）之间在相同时点MDA、NAG／Cr和β2-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 β2-MG during the postoperative 24 hours. Results： On the first day after ESML, the MDA, NAG/Cr and β2-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 β2-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 132-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 sepa- rate groups （Ulinastain group and Nifedipine group） showed no significant difference at the same time. Conclusion： Ulinastatin had the function of eliminate fxee radicals and relieve peroxide of lipid, which could lighten the kidney damage and the efficacy of ulinastatincombined with Calcium antagonists was better.