目的 观察前列地尔注射液联合百令胶囊治疗儿童急性肾衰竭的临床疗效。方法 选取2014年6月-2016年1月湖北省十堰市太和医院收治的急性肾衰竭患儿244例，随机分为常规组、前列地尔组、百令胶囊组和联合组，每组各61例。常规组给予患儿及时解除病因的治疗。前列地尔组在常规组的基础上静脉滴注前列地尔注射液，5 μg加入100 mL生理盐水，1次/d，滴速为5 ng/(kg·min)。百令胶囊组在常规组的基础上饭后口服百令胶囊，3粒/次，3次/d。联合组为前列地尔组与百令胶囊组给药方法的联用。4组患儿均连续治疗2周。观察4组患儿的临床疗效，并比较4组患儿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）、乳酸脱氢酶5（LDH5）、丙二醛（MDA）、血肌酐（Scr）、尿素氮（BUN）和胱抑素C（Cys-C）的量变化。结果 治疗后，常规组总有效率为86.88%，前列地尔组总有效率为90.16%，百令胶囊组总有效率为91.80%，联合组总有效率为98.36%，其中前列地尔组、百令胶囊组和联合组的总有效率均高于常规组（P<0.05），且治疗后联合组的总有效率明显高于前列地尔组和百令胶囊组（P<0.05）。治疗后，4组患儿UAER、mALB和β2-MG均较治疗前明显降低（P<0.05）；且前列地尔组、百令胶囊组和联合组的上述指标均比常规组明显降低，3组与常规组比较差异均具有统计学意义（P<0.05）。且联合组的上述指标比前列地尔组和百令胶囊组均显著降低，与两组比较差异均具有统计学意义（P<0.05）。治疗后，常规组和前列地尔组的MDA和LDH5均较治疗前明显降低（P<0.05），而两组SOD无明显变化。百令胶囊组和联合组的MDA和LDH5均较治疗前明显降低，而SOD升高，同组治疗前后差异具有统计学意义（P<0.05）；且百令胶囊组和联合组的上述指标比常规组和前列地尔组均明显改善，与两组比较差异均具有统计学意义（P<0.05）。治疗后，4组患儿Scr、BUN和Cys-C均较治疗前明显降低（P<0.05）；且前列地尔组、百令胶囊组和联合组上述指标均比常规组明显降低，3组与常规组比较差异均具有统计学意义（P<0.05）。且联合组的上述指标比前列地尔组和百令胶囊组均显著降低，与两组比较差异均具有统计学意义（P<0.05）。结论 前列地尔注射液联合百令胶囊治疗儿童急性肾衰竭具有较好疗效，可增强SOD活性，且能扩张肾血管增加流量，减轻肾功能损害，促进衰竭肾功能恢复。

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.

湖北省教育厅重点项目（D20122402）