前列地尔对冠状动脉介入诊疗术患者造影剂肾病的预防作用

Preventive effect of alprostadil on contrast-induced nephropathy in patients undergoing coronary intervention

目的观察前列地尔对冠状动脉介入诊疗术患者造影剂肾病（CIN）的预防作用。方法将215例接受冠状动脉介入诊疗术患者按随机数字表法分为治疗组（112例）和对照组（103例），对照组给予常规治疗，治疗组在常规治疗的基础上从术前1d开始给予前列地尔10IXg＋0．9％氯化钠10ml静脉推注，每天2次，连用7～10d。观察两组的合并症及CIN发生情况等。结果治疗组CIN发生率明显低于对照组[7．1％（8／112）比18．4％（19／103），P〈0．05]。肾功能不全患者CIN发生率明显高于肾功能正常患者[51．6％（16131）比6．0％（11／184），P〈0．01]。糖尿病患者CIN发生率明显高于非糖尿病患者[22．1％（15／68）比8．2％（12／147），P〈0．01]。结论在行冠状动脉介入诊疗术前给予患者前列地尔能明显减少CIN的发生，要注意肾功能不全和糖尿病患者更易发生CIN。

Objective To observe the preventive effect of alprostadil on contrast-induced nephropathy （CIN） in patients undergoing coronary intervention. Methods Two hundred and fifteen patients undergoing coronary intervention were divided into treatment group （112 cases） and control group （ 103 cases） by random digits table method. Patients in treatment group were treated routinely with addition of alprostadil （ 10 μ g intravenous injection every 12 h once for 7 - 10 days,given before surgery）. Patients in control group were given routine therapy only. Complications of the two groups and CIN occurrence were observed. Results The occurrence rate of CIN in treatment group was lower than that in control group [ 7.1% （8/112） vs. 18.4% （19/103）, P 〈 0.05 ]. The occurrence rate of CIN in patients with renal insufficiency was higher than that in patients with normal renal function [51.6% （ 16/31 ） vs. 6.0% （11/184） ,P 〈 0.01 ]. The occurrence rate of CIN in patients with diabetes was higher than that in patients without diabetes[22.1% （15/68） vs. 8.2%（ 12/147 ） ,P 〈 0.01 ]. Conclusions Alprostadil in coronary intervention before treatment can obviously reduce the incidence of CIN. CIN is more likely to occur in patients with renal insufficiency or with diabetes.