静脉水化联合前列地尔对冠状动脉介入术后对比剂肾病的预防作用

Inhibitory Effect of Intravenous Hydration Combined with Alprostadil on Contrast-induced Nephropathy in Patients with Percutaneous Coronary Intervention

目的:观察静脉水化联合前列地尔对冠状动脉介入(PCI)术后对比剂肾病(CIN)的预防作用。方法:选择行PCI术的患者80例,随机分为对照组38例(常规静脉水化)和试验组42例(常规静脉水化联合前列地尔)。观察两组患者PCI术前和术后24、48、72h及7d时的血清肌酐(Scr)、血尿素氮(BUN)、尿β2-微球蛋白(β2-mG),比较两组患者CIN的发生率,记录不良反应发生情况。结果:两组患者术后24hScr、BUN、尿β2-mG比较差异均无统计学意义(P>0.05);试验组术后48、72h及7d时的Scr、BUN、尿β2-mG下降较对照组同期更为显著,差异有统计学意义(P<0.05或P<0.01)。对照组CIN发生率(5例,13.1%)显著高于试验组(3例,7.1%),差异有统计学意义(P<0.05)。两组患者均未见不良反应发生。结论:接受PCI术的患者,在常规静脉水化基础上加用前列地尔可显著降低CIN的发生率,且安全性较好。

OBJECTIVE：To investigate the inhibitory effect of intravenous hydration combined with alprostadil on contrast-induced nephropathy（CIN） in patients underwent percutaneous coronary intervention（PCI）.METHODS：80 patients underwent PCI were randomized into control group（38 cases,conventional intravenous hydration） and trial group（42 cases,conventional intravenous hydration＋alprostadil）.The levels of Scr,BUN and urinary β2-microglobulin（β2-mG） were compared between 2 groups before PCI and 24 h,48 h,72 h and 7 d after PCI.The incidence of CIN was also compared.RESULTS：There was no significant difference in SCr,BUN and urinary β2-mG level between 2 groups 24 h after operation（P0.05）;the decrease of Scr,BUN and urinary β2-mG levels in experimental group were more significant than in control group 48 h,72 h and 7 d after operation,there was statistical significance（P0.05 or P0.01）;there were 5 cases of CIN（13.1%） in control group,while 3 cases（7.1%） in experiment group,there was statistical significance（P0.05）.CONCLUSIONS：Intravenous hydration is main measure to prevent the occurrence of CIN in patients underwent PCI.Intravenous hydration combined with alprostadil could obviously reduce the incidence of CIN.