Cov ntaub ntawv AKI ntawm cov neeg mob tom qab kev phais loj hauv Suav teb tau tso tawm. 4 Daim duab no tsim nyog xav txog.

Nws paub zoo tias mob raum raug mob (AKI) yog ib qho teeb meem tshwm sim hauv cov neeg mob hauv tsev kho mob thiab cuam tshuam rau cov neeg mob hnyav. Txawm tias luv luv thiab me me AKI cuam tshuam nrog kev pheej hmoo ntawm kev tuag ntau dua. Tsis ntev los no, ib daim ntawv ntsuam xyuas Suav tau qhia tias AKI suav txog 10% ntawm tag nrho cov nqi kho mob, uas muaj kev cuam tshuam loj rau tib neeg, tsev neeg, tib neeg, thiab cov tsev kho mob.

Nyem rau Cistanche rau mob raum

Raws li cov laj thawj saum toj no, cov kws kho mob nto moo Suav xws li Academician Hou Fanfan thiab Xu Gang tau ua tus thawj coj hauv kev txheeb xyuas qhov xwm txheej, kev pheej hmoo, thiab kev mob tshwm sim tom qab AKI hauv Suav cov neeg mob. Cov txiaj ntsig ntawm kev tshawb fawb tau tshaj tawm tsis ntev los no ntawm NDT. Ntawm lawv, muaj 4 tus lej tsim nyog xav txog.

4 cov ntaub ntawv tseem ceeb

National postoperative AKI qhov tshwm sim: 5.0%

Kev siv lub raum hloov kho: 7.7%

Kev saib xyuas mob hnyav (ICU) tus nqi siv: 45.0%

Hauv tsev kho mob tus nqi tuag: 4.0%

Kev tshawb fawb tsim

Qhov no yog ib qho kev tshawb nrhiav rov qab, nrog cov ntaub ntawv los ntawm Tuam Tshoj Kab Mob Raum Cov Ntaub Ntawv (CRDS), suav nrog 16 lub tsev kho mob qib siab hauv 10 lub xeev. Cov neeg laus uas tau phais los ntawm 2013 txog 2019 tau suav nrog. Txawm li cas los xij, vim cov qauv me me, cov neeg mob hloov lub raum tsis suav nrog. Cov txheej txheem cais tawm yog: (1) Kev nyob hauv tsev kho mob tsawg dua lossis sib npaug li 1 hnub; (2) Kev phais mob nephrectomy; (3) Cov neeg mob uas muaj kab mob raum kawg, txhais tau tias kwv yees glomerular filtration rate (eGFR)<15 ml/(min·1.73m2) , or have received renal replacement therapy before surgery. The definition and staging of AKI in this study followed the KDIGO standards.

Cov ntsiab lus tseem ceeb ntawm txoj kev tshawb no yog kev tuag hauv tsev kho mob, thiab lwm cov ntsiab lus kawg suav nrog tag nrho lub sijhawm nyob, tag nrho cov nqi mus pw hauv tsev kho mob, xav tau ICU, thiab xav tau kev kho lub raum.

Kev tshawb fawb tshwm sim

Tag nrho ntawm 520,707 kev phais tau suav nrog. Cov hom kev phais feem ntau yog kev phais dav dav (32.5%), tom qab ntawd orthopedics (16.1%) thiab gynecology (13.7%). Kev phais mob xwm txheej ceev tsuas yog 1.5%. Qhov nruab nrab hnub nyoog yog 54 xyoo, 45.9% yog txiv neej, thiab qhov nruab nrab eGFR yog 98 ml / (min·1.73m2). Nws yog ib nqi sau cia hais tias 4.4% ntawm cov neeg mob muaj ib tug hauv paus eGFR<60 ml/(min·1.73m2).

01 Qhov xwm txheej ntawm AKI

Tag nrho ntawm 25,830 cov neeg mob tsim AKI, suav txog 5.0%. Kev faib ua feem ntawm AKI theem 1, theem 2 thiab theem 3 yog 77.3%, 15.4%, thiab 7.3% feem. Tsis tas li ntawd, qhov kev pheej hmoo ntawm AKI tom qab kev phais sib txawv yog qhov sib txawv, nrog rau qhov kev pheej hmoo siab tshaj plaws yog kev phais plawv (34.6%), tom qab ntawd los ntawm kev phais urological (8.7%) thiab phais dav dav (4.2%). Dab tsi xav tau kev saib xyuas ntxiv yog tias AKI hnyav kuj tseem tshwm sim tom qab kev phais mob plawv (AKI theem 2 thiab 3; 29.3%), tom qab ntawd los ntawm neurosurgery (23.8%). Tsis tas li ntawd, qhov tshwm sim ntawm AKI hauv kev phais xwm txheej ceev yog 5.9% siab dua li hauv kev xaiv phais (4.9%).

Tsis tas li ntawd, feem ntau tom qab phais AKI tau kuaj pom thawj hnub tom qab (72.7%), thiab tus lej me (1.5%) ntawm cov neeg mob tau kuaj pom nyob rau hnub xya tom qab phais.

02 Prognosis of AKI

Ntawm tag nrho cov neeg mob uas tsim AKI, tsuas yog 1053 (5.5%) cov neeg mob raug suav hais tias muaj AKI ncua sijhawm. Raws li qhov xeem creatinine xeem, 19 655 cov neeg mob (78.4%) rov qab mus rau qhov qub, thaum ntawm cov neeg mob AKI theem 3, tsuas yog 859 (52.8%) cov neeg mob muaj lub raum ua haujlwm.

Qhov tseem ceeb, 1025 (4.0%) cov neeg mob tom qab phais AKI tuag thaum mus pw hauv tsev kho mob. Kaplan-Meier ciaj sia taus txoj kev tshawb fawb pom tau tias raws li AKI theem nce, kev pheej hmoo ntawm kev tuag hauv tsev kho mob tau nce ntau.

Tsis tas li ntawd, piv nrog cov neeg mob tom qab phais tsis muaj AKI, cov neeg mob AKI tau lub sijhawm pw hauv tsev kho mob ntev dua (12 d vs 19 d), cov nqi siab dua (38 000 yuan vs 82 000 yuan), thiab feem ntau yuav tau txais Kev kho ICU (13.1% vs 45.0%) thiab feem ntau yuav tau txais kev kho mob raum (0.4% vs 7.7%).

kev sib tham tshawb fawb

Hauv qhov kev tshawb fawb loj, ntau qhov chaw rov qab los, qhov tshwm sim ntawm kev ua haujlwm tom qab AKI hauv Suav teb yog 5.0%, nrog rau kev pheej hmoo siab tshaj ntawm AKI tshwm sim tom qab phais plawv. Feem ntau AKI tuaj yeem kuaj tau hauv 2 hnub tom qab kev phais.

AKI yog ib qho teeb meem tom qab phais hauv Suav cov neeg mob plawv. Nyob ib ncig ntawm lub ntiaj teb no, cov neeg mob phais plawv kuj muaj feem rau AKI. Hauv xyoo 2016, kev tshuaj ntsuam xyuas meta uas suav nrog 91 cov kev tshawb fawb thiab 320,086 cov neeg mob phais plawv tau pom tias qhov tshwm sim ntawm AKI tom qab phais plawv yog 22.3%. Cov kev tshawb fawb cuam tshuam nrog rau US cov qub tub rog tau pom tias qhov tshwm sim yog 18.7%. Txawm li cas los xij, txoj kev tshawb fawb no pom tias qhov tshwm sim ntawm AKI hauv Suav cov neeg mob tom qab kev phais plawv mus txog 34.6%, thiab 30% ntawm AKI yog theem 2 lossis 3, qhia tias Tuam Tshoj yuav tsum tau txhim kho ntxiv kev tiv thaiv tom qab AKI rau cov neeg mob phais plawv.

Txoj kev tshawb no tseem pom tias feem ntau tom qab kev phais AKI tau kuaj pom hauv 2 hnub (48 teev), qhia tias kev cuam tshuam yuav tsum tau ntxiv dag zog ua ntej thiab thaum lub sijhawm phais, xws li txo qis kev siv tshuaj nephrotoxic ua ntej thiab tsis txhob haus dej ntau dhau, thiab lwm yam kev ceev faj. Tsis tas li ntawd, hauv kev kho mob, qee tus kws kho mob nyiam ua cov tshuaj creatinine hauv 48 teev tom qab kev phais. Yog tias tsis muaj qhov txawv txav hauv qhov kev sim no, yuav tsis muaj kev sim ntxiv, uas yuav ua rau tsis muaj kev kuaj mob ntawm AKI lig. Tsis tas li ntawd, qhov txo qis hauv cov leeg nqaij tom qab phais yuav yog qhov laj thawj tseem ceeb rau kev kuaj pom tus nqi ntawm AKI tom qab lig.

Thaum kawg, txoj kev tshawb fawb no kuj pom tau tias nyob hauv tsev kho mob ua ntej muaj kev sib raug zoo U-zoo li AKI tom qab phais. Yog tias lub sijhawm pw hauv tsev kho mob ua ntej luv dhau, nws qhia tau hais tias qhov xwm txheej ceev ntawm kev phais yog siab thiab yuav tsis muaj kev npaj zoo; yog tias lub sijhawm pw hauv tsev kho mob ua ntej ntev dhau lawm, nws qhia tau tias tus neeg mob cov tsos mob hnyav dua. Lwm yam cuam tshuam nrog kev ua haujlwm tom qab AKI yog cov hnub nyoog laus dua, txiv neej poj niam txiv neej, qis qis hauv lub raum ua haujlwm, thiab muaj cov kab mob sib kis. Rau cov neeg mob uas muaj cov xwm txheej saum toj no, cov kws kho mob yuav tsum xav txog kev saib xyuas tom qab AKI.

Zuag qhia tag nrho, txoj kev tshawb no qhia tau hais tias tom qab kev phais AKI yog lub nra tseem ceeb hauv kev kho mob hauv Suav teb, tshwj xeeb tshaj yog cov neeg mob phais plawv. Tsis tas li ntawd, qhov kev kuaj tsis tau ntawm AKI yog siab. Yog li ntawd, nws yog ib qho tseem ceeb los txhim kho Tuam Tshoj txoj kev nkag siab ntawm postoperative AKI thiab ua raws li kev ceeb toom ntxov. Txoj kev tshawb no kuj tau nthuav tawm cov kev pheej hmoo rau kev phais tom qab AKI hauv ntau hom kev phais, muab cov ntaub ntawv tseem ceeb rau kev txhim kho AKI cov tswv yim tiv thaiv.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rau lub raum kev noj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tshuab.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.