解毒化瘀法对老年稳定性心绞痛患者造影剂肾病的预防作用

Effect of resolving toxin and dissolving stasis method in prevention of contrast-induced nephropathy in elderly patients with stable angina pectoris

[目的]探讨解毒化瘀法对老年稳定性心绞痛患者造影剂肾病(CIN)的预防作用。[方法]将184例拟行冠状动脉介入(PCI)治疗的老年稳定性心绞痛患者随机分为对照组(90例)和观察组(94例),两组在西药常规治疗基础上,观察组在术前3d至术后3d给予解毒化瘀法治疗。所有患者术前及术后3d连续测定血清肌酐(Scr),术前、术后24 h和48 h测定尿胱抑素C(Cys-c)、尿白细胞介素-18(IL-18)、肾损伤分子-1(KIM-1)水平,比较两组CIN的发病率。[结果]观察组术后Scr、尿Cys-c、IL-18、KIM-1水平低于对照组(P<0.01)。两组共发生CIN 19例(10.33%),观察组发生CIN4例(4.26%),对照组发生15例(16.67%),两组比较差异有统计学意义(P<0.05)。[结论]解毒化瘀法可以有效预防老年稳定性心绞痛患者PCI术后造影剂肾病的发生。

[Objective] To investigate the effects of resolving toxin and dissolving stasis method in prevention of contrast-induced nephropathy （CIN） in elderly patients with stable angina pectoris. [Methods] The 184 elderly patients with stable angina pectoris were randomized into two groups, 90 in the control group and 94 in the treated group. On the base of conventional Western medicinal therapy, the treated group was given resolving toxin and dissolving stasis method from preoperative 3 d to postoperative 3 d in angioplasty. The values of serum creatinine （Scr） was detected before angioplasty and for continuous 3 d after angioplasty. Then the values of urine Cys-c, IL-18 and KIM-1 were measured and compared 24 hours and 48 hours after contrast administration. The incidence rates of CIN were compared between two groups. [Results] The levels of Scr, urine Cys-c, IL-18 and KIM-1 were lower in the treated group than those in the control group after contrast administration （P〈0.01）. CIN occurred in 19 cases （10.33%）. There were 4 cases（4.26%）of CIN in the treated group as compared to 15 cases （16.67%） in the control group,which had significant difference （P〈0.05）. [Conclusion] Resolving toxin and dissolving stasis method can effectively prevent CIN in elderly patients with stable angina pectoris underwent the percutaneous coronary intervention.