普罗布考对冠心病合并糖尿病患者经皮冠状动脉介入术后对比剂肾病的影响

Effect of probucol on contrast-induced nephropathy in patients with coronary heart disease complicated with type 2diabetes undergoing percutaneous coronary intervention

目的：观察普罗布考对冠心病合并糖尿病患者经皮冠状动脉介入术（PCI）后对比剂肾病（CIN）的预防作用,探讨其可能机制.方法：将90例择期行PCI的冠心病合并糖尿病患者随机分为治疗组（46例）及对照组（44例）.治疗组在常规治疗基础上,于术前3～5d开始服用普罗布考0.5g/次,2次/d.入院时及术后24、48、72 h测定血肌酐（SCr）和胱抑素C（CysC）水平,检测患者术前及术后3d血超敏C反应蛋白（hsCRP）、脂质过氧化物（MDA）、一氧化氮（NO）、内皮素-1（ET-1）水平变化.结果：治疗组CIN发生率显著低于对照组（6.5％ vs 15.9％,P＜0.05）;治疗组术后3d hsCRP、MDA及ET-1水平低于对照组（P＜0.05）,而术后3d血浆NO水平高于对照组（P＜0.05）.结论：普罗布考能抑制PCI术后炎症反应,减轻脂质过氧化损伤,改善内皮功能,预防CIN发生.

Objective ： To observe the protective effects of probucol on contrast-induced nephropathy （CIN） after percu- taneous coronary intervention （PCI） in patients with coronary heart disease complicated with type 2 diabetes and to explore its possible mechanism. Methods ： A total of 90 patients with coronary heart disease complicated with diabetes admitted for e- lective PCI were randomly divided into the therapy group（46 cases） and control group （44 cases）. All patients were treated with conventional medicine. Accessory to the conventional medicine, the therapy group was administered with 500 mg probu- col two times a day for 3 -5 days before PCI. Concentrations of serum creatinine （Scr） and CystatinC （CysC） were detected at admission, 24 hours,48 hours and 72 hours after PCI. Serum levels of hsCRP, malondialdehyde （MDA）, NO and ET-1 were determined before and 3 days after PCI. Results ： The incidence of CIN in therapy group was significantly lower than that of control group （6.5 % vs 15.9%, P 〈 0.05 ）. The levels of hsCRP, MDA and ET-1 in therapy group were lower than those in control group at 3 days after PCI, while the level of NO was higher than that in control group （ P 〈 0.05 ）. Conclusions ： Probucol may antioxidize, inhibit inflammation and improve endothelial function after PCI and to prevent CIN.