水化加前列地尔对老年患者介入术后肾损伤的保护作用

Effect of alprostadil on contrast-induced nephropathy in senile patients after percutaneous coronary intervetition

目的探讨水化加前列地尔对老年患者PCI术后肾损伤的保护作用及预防对比剂肾病的效果。方法选择老年冠心病患者60例。随机分为2组:对照组26例(常规水化),实验组34例(前列地尔+常规水化)。于PCI术前、术后48h、造影后第7天分别测定血肌酐、血尿素及尿β_2微球蛋白水平。结果与对照组比较,实验组患者PCI术后48h及造影后第7天血肌酐、血尿素和尿β_2微球蛋白明显降低,差异有统计学意义(P<0.05)。实验组患者对比剂肾病2例,发生率为5.9%;对照组对比剂肾病3例,发生率为11.5%,实验组对比剂肾病发生率明显低于对照组,差异有统计学意义(P<0.05)。结论在水化基础上,PCI术前使用前列地尔注射液可明显改善老年患者术后的肾脏功能,明显降低对比剂肾病的发生率。

Objective To explore the efficacy of alprostadil in protection of renal function and in the prevention of contrast-induced nephropathy （CIN） in senile patients who underwent PCI. Methods Sixty senile patients were randomly divided into 2 groups. In the control group （n =26）, the patients only accepted routine hydration treatment by intravenous infusion of 0.9 % sodium chloride solution. In the experimental group, besides the hydration treatment, the patients also accepted intravenous infusion of alprostadil injection 30 rain before the PCI in 20 μg,qd,continually for 3 days. Scr,BU,and urine 132 microglobulin were detected before PCI,and 48 hours,7 days after PCI in all patients. Results According to the lab examinations at 48 hours and 7 days after PCI,the renal functions of the patients in the experimental group were significantly better than those in the control group,their Scr and BU returned to normal level. The incidence of CIN in the experimental group was significantly less than that in the control group, there were 2 cases of CIN （5. 9%） in the experimental group, while in the control group there were 3 cases of CIN （11.5%） ,the difference between the two groups had statistical significance （P （0.05）. Conclusion Compared with treatment with hydration only, application of alprostadil injection before PCI could obviously improve the renal functions of the senile patients, and significantly decrease the incidence of contrast-induced nephropathy.