学术论文

      前列地尔对冠心病合并糖尿病患者介入治疗中预防对比剂肾病的影响

      Preventive effect of alprostadil on contrast-induced nephropathy in patients with coronary heart disease complicating diabetes undergone percutaneous coronary intervention

      摘要:
      目的:探讨前列地尔对冠状动脉粥样硬化性心脏病(冠心病)合并糖尿病患者介入治疗中预防对比剂肾病的作用。方法选取自2008年6月~2014年1月咸阳市中心医院经介入治疗的冠心病合并糖尿病患者86例,其中男性45例、女性41例,平均年龄(60.3±14.3)岁,均有不同程度的肾脏损害。随机分为观察组和治疗组各43例,观察组中男性23例,女性20例,平均年龄(61.2±13.7)岁,对照组中:男性22例,女性21例,平均年龄(59.4±14.9)岁。对照组给予降血脂,抗血小板凝集及水化等常规治疗,观察组在对照组的治疗基础上,于冠状动脉造影(CAG)术前30min给予前列地尔10μg,经100 ml生理盐水稀释后静脉滴入,术后静脉注射3d,比较两组患者造影后肾功能及对比剂肾病发生的情况。结果观察组及对照组术前尿素氮(BUN)、肌酐(Scr)、肾小球滤过率(GFR)相比,差异无统计学意义(P>0.05);与术前比较,术后24h GFR,差异具有统计学意义(P<0.05);术后72h BUN, Scr,GFR比较,差异具有统计学意义(P<0.05)。观察组血液透析率,住院天数与对比剂肾病发生率与对照组比较,差异具有统计学意义(P<0.05)。结论前列地尔可明显预防冠心病合并糖尿病患者对比剂肾病的发生,改善肾功能,降低血液透析及住院天数。
      Abstract:
      Objective To investigate the effect of alprostadil in preventing contrast-induced nephropathy (CIN) in patients with coronary heart disease (CHD) complicating diabetes undergone percutaneous coronary intervention (PCI).Methods The patients (n=86, male 45, female 41 and average age=60.3±14.3) were chosen from Jun. 2008 to Jan. 2014. All patients had renal injury in varying degrees, and divided randomly into observation group (n=43, male 23, female 20 and average age=61.2±13.7) and control group (n=43, male 22, female 21 and average age=59.4±14.9). The control group was given anti-hyperlipidemia, anti-platelet aggregation and hydration therapies, and observation group was additionally given intravenous drip of alprostadil (10 μg, diluted with normal saline solution) 30 min before coronary angiography (CAG) and given venous injection 3 d after PCI. The kidney function and incidence of CIN were compared in 2 groups.Results The difference in blood urea nitrogen (BUN), serum creatinine (Scr) and glomerular filtration rate (GFR) had no statistical significance between 2 groups before PCI (P>0.05). After PCI for 24 h, the difference in GFR had statistical significance (P<0.05), and difference in BUN, Scr and GFR had statistical significance (P<0.05) after PCI for 72 h in 2 groups. The difference in rate of hematodialysis, hospitalization days and residence of CIN had statistical significance (P<0.05) between 2 groups. Conclusion Alprostadil can significantly prevent the occurrence of CIN, improve kidney function, and reduce rate of hematodialysis and hospitalization days in patients with CHD complicating diabetes.
      Author: SUN Xiao-xia WANG A-li ZUO Hong QIN Li-ming
      作者单位: 咸阳市中心医院心内科, 咸阳,712000
      年,卷(期): 2015, (5)
      分类号: R692
      机标分类号: R15 R97
      在线出版日期: 2015年11月17日