Effects of ulinastatin combined with furosemide on myocardial enzymes,renal function and adverse reactions in patients with acute renal failure after cardiopulmonary resuscitation / 中国基层医药

ABSTRACT

Objective To explore the effects of ulinastatin combined with intravenous pump injection of furosemide on myocardial enzymes ,renal function and adverse reactions in patients with acute renal failure ( ARF) after cardiopulmonary resuscitation (CPR).Methods From January 2016 to May 2018,117 patients with ARF after successful CPR in the Second Peopleˊs Hospital of Hefei were divided into observation group ( n ＝59) and control group(n＝58) using simple random method.The control group received routine treatment ,while the observation group added ulinastatin combined with intravenous pump infusion of furosemide .Myocardial enzymology, renal function, metabolism,inflammatory index,adverse reaction and survival rate were compared.Results Three and 7 days after treatment,the hydroxybutyrate dehydrogenase ( HDBH), isoenzymes of creatine kinase isoenzyme ( CK －MB) and mitochondrial aspartate aminotransferase isoenzyme (m－AST) were decreased in the two groups ,and compared with the control group,which of the observation group were lower [HDBH(231.42 ±31.15)U／L vs.(268.59 ±34.87)U／L; F＝12.01,P＝0.00;CK－MB(32.38 ±4.15)ng／mL vs.(37.57 ±3.96) ng／mL;F＝15.12,P＝0.00;m－AST(25.18 ±4.24) U／L vs.(33.92 ±5.60) U／L;F＝12.36,P＝0.00].After treatment,the blood urea nitrogen (BUN),24h urine protein quantity and creatinine ( Cr) in the two groups increased firstly and then decreased ,and compared with the control group ,those of the observation group were lower [BUN(7.02 ±1.66)mmol／L vs.(8.47 ± 1.38)mmol／L;F＝11.24,P＝0.00;Cr(82.69 ±9.87) μmol／L vs.(90.18 ±10.37) μmol／L;F＝10.39,P＝0.00;24h urine protein quantity(15.43 ±2.17) mg vs.(18.62 ±3.14) mg;F＝11.06,P＝0.00].Three and 7 days after treatment,the levels of blood lactic acid (Lac),hypersensitive C－reactive protein(hs－CRP) and tumor necrosis factor－α( TNF－α) were decreased in the two groups ,and compared with the control group ,those of the observation group were lower [ Lac(1.18 ±0.27) mmol／L vs.(2.17 ±0.34) mmol／L,F ＝16.29, P ＝0.00;hs－CRP(4.89 ±0.81)mg／L vs.(6.17 ±1.10) mg／L,F＝13.41,P＝0.00;TNF－α(72.18 ±7.62) ng／L vs. (83.16 ±7.79)ng／L,F＝11.39,P＝0.00].The incidence rates of adverse reactions in the observation group and the control group were 5.09% and 1.72%,respectively,the difference was statistically significant (χ2 ＝0.24,P＝0.62).The survival rates in the observation group and the control group were 50 cases (84.75%) and 39 cases (67.24%) respectively,the difference was statistically significant (χ2 ＝4.92,P＝0.02).Conclusion Intravenous pump injection of furosemide combined with ulinastatin can protect the heart and kidney ,and improve the survival rate of patients with ARF after CPR and it is worthy of popularizing.