目的 觀察前列地爾注射液聯(lián)合百令膠囊治療兒童急性腎衰竭的臨床療效。方法 選取2014年6月-2016年1月湖北省十堰市太和醫(yī)院收治的急性腎衰竭患兒244例，隨機(jī)分為常規(guī)組、前列地爾組、百令膠囊組和聯(lián)合組，每組各61例。常規(guī)組給予患兒及時(shí)解除病因的治療。前列地爾組在常規(guī)組的基礎(chǔ)上靜脈滴注前列地爾注射液，5 μg加入100 mL生理鹽水，1次/d，滴速為5 ng/(kg·min)。百令膠囊組在常規(guī)組的基礎(chǔ)上飯后口服百令膠囊，3粒/次，3次/d。聯(lián)合組為前列地爾組與百令膠囊組給藥方法的聯(lián)用。4組患兒均連續(xù)治療2周。觀察4組患兒的臨床療效，并比較4組患兒β2微球蛋白（β2-MG）、尿微量白蛋白（mALB）、尿微量白蛋白排泄率（UAER）、超氧化物歧化酶（SOD）、乳酸脫氫酶5（LDH5）、丙二醛（MDA）、血肌酐（Scr）、尿素氮（BUN）和胱抑素C（Cys-C）的量變化。結(jié)果 治療后，常規(guī)組總有效率為86.88%，前列地爾組總有效率為90.16%，百令膠囊組總有效率為91.80%，聯(lián)合組總有效率為98.36%，其中前列地爾組、百令膠囊組和聯(lián)合組的總有效率均高于常規(guī)組（P<0.05），且治療后聯(lián)合組的總有效率明顯高于前列地爾組和百令膠囊組（P<0.05）。治療后，4組患兒UAER、mALB和β2-MG均較治療前明顯降低（P<0.05）；且前列地爾組、百令膠囊組和聯(lián)合組的上述指標(biāo)均比常規(guī)組明顯降低，3組與常規(guī)組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。且聯(lián)合組的上述指標(biāo)比前列地爾組和百令膠囊組均顯著降低，與兩組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，常規(guī)組和前列地爾組的MDA和LDH5均較治療前明顯降低（P<0.05），而兩組SOD無(wú)明顯變化。百令膠囊組和聯(lián)合組的MDA和LDH5均較治療前明顯降低，而SOD升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且百令膠囊組和聯(lián)合組的上述指標(biāo)比常規(guī)組和前列地爾組均明顯改善，與兩組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，4組患兒Scr、BUN和Cys-C均較治療前明顯降低（P<0.05）；且前列地爾組、百令膠囊組和聯(lián)合組上述指標(biāo)均比常規(guī)組明顯降低，3組與常規(guī)組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。且聯(lián)合組的上述指標(biāo)比前列地爾組和百令膠囊組均顯著降低，與兩組比較差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 前列地爾注射液聯(lián)合百令膠囊治療兒童急性腎衰竭具有較好療效，可增強(qiáng)SOD活性，且能擴(kuò)張腎血管增加流量，減輕腎功能損害，促進(jìn)衰竭腎功能恢復(fù)。

Objective To observe the clinical effect of Alprostadil Injection combined with Corbrin Capsules in treatment of children with acute renal failure. Methods Children (244 cases) with acute renal failure in Shiyan Taihe Hospital in Hubei from June 2014 to January 2016 were randomly divided into conventional, alprostadil, Corbrin Capsules and combination groups, and each group had 61 cases. The children in the conventional group were given timely treatment to remove the etiology. The children in alprostadil group were iv administered with Alprostadil Injection on the basis of the conventional group, 5 μg added into normal saline 100 mL, and the dropping speed was 5 ng/(kg·min), once daily. The children in the Bailing Capsules were po administered with Corbrin Capsules on the basis of the conventional group, 3 grains/time, three times daily. The treatment method in the combination group was the combination of the medication of alprostadil and Corbrin Capsules groups. The children in four groups were treated for 2 weeks. After treatment, the efficacy was observed, and hs-CRP, IL-6, and the changes of β2-MG, mALB, UAER, SOD, LDH5, MDA, Scr, BUN, and Cys-C levels in four groups were compared. Results After treatment, the efficacies in the conventional, alprostadil, Corbrin Capsules, and combination groups were 86.88%, 90.16%, 91.80%, and 98.36%, respectively, and the efficacies in the alprostadil and Corbrin Capsules groups were significantly higher than that in the conventional group (P<0.05). And the efficacy in the combination group was significantly higher than those in the alprostadil and Corbrin Capsules groups (P<0.05). After treatment, UAER, mALB, and β2-MG in four groups were significantly decreased (P<0.05). And those indexes in the alprostadil, Corbrin Capsules, and combination groups were significantly lower than those in the conventional group (P<0.05). After treatment, those indexes in the combination group were significantly lower than those in the alprostadil and Corbrin Capsules groups (P<0.05). After treatment, MDA and LDH5 in conventional and alprostadil groups were significantly decreased (P<0.05), and SOD had no significant change. After treatment, MDA and LDH5 in the Corbrin Capsules and combination groups were significantly decreased, and SOD was significantly increased, and the differences were statistically significant in the same group (P<0.05). And those indexes in the Corbrin Capsules and combination groups were significantly better than those in the conventional and alprostadil groups (P<0.05). After treatment, Scr, BUN, and Cys-C in four groups were significantly decreased (P<0.05). And those indexes in the alprostadil, Corbrin Capsules, and combination groups were significantly lower than that in the conventional group (P<0.05). After treatment, those indexes in the combination group were significantly lower than those in the alprostadil and Corbrin Capsules groups (P<0.05). Conclusion Alprostadil Injection combined with Corbrin Capsules has a good efficacy in treatment of children with acute renal failure, can enhance SOD activity, and dilate renal vessels to increase the blood flow, and reduce kidney damage, also can promote the recovery of renal function in renal failure.

湖北省教育廳重點(diǎn)項(xiàng)目（D20122402）