金水宝联合水化治疗预防肾功能不全患者造影剂肾病的临床研究

Jinshuibao capsules combined with hydration therapy for prevention of contrast-induced nephropathy in patients with renal insufficiency:A clinical research

目的:探讨金水宝胶囊联合水化治疗对预防肾功能不全患者的造影剂肾病的价值。方法:将2012年7月至2014年6月普宁市人民医院收治的拟行冠脉造影的120例肾功能不全患者随机分为3组即联合治疗组、单纯水化组和对照组。每组40例。联合治疗组接受金水宝胶囊口服治疗+水化治疗+常规治疗;单纯水化组接受水化治疗+常规治疗;对照组仅接受常规治疗。比较3组患者术前,术后1、3、7 d血肌酐(Scr)及血尿素氮(BUN)的动态变化。结果:与术前比较,对照组和单纯水化组术后1 d Scr水平显著升高,术后3 d达高峰,术后7 d回落至术前水平(P<0.05)。联合治疗组Scr水平未出现术后先增加后回落的趋势,术后水平与术前相当(P>0.05)。与术前比较,对照组和单纯水化组BUN水平持续走高(P<0.05)。联合治疗组术后各时相点BUN水平与术前相当(P>0.05)。联合治疗组、单纯水化组、对照组患者造影剂肾病发生率分别为2.5%、5.0%、20.0%,3组比较,差异有统计学意义(P<0.05)。结论:肾功能不全患者行冠脉造影时,同时给予金水宝胶囊联合水化治疗较单纯水化治疗更能预防造影剂肾病。

Objective：To investigate the clinical value of Jinshuibao Capsules combined with hydration therapy for the prevention of contrast-induced nephropathy in patients with renal insufficiency. Methods： 120 cases of patients with renal insufficiency,who admitted in Puning People′s Hospital between July 2012 and June 2014 and were scheduled for coronary angiography,were randomly divided into the combination treatment group, simple hydration therapy group and control group （n=40 each）.The combination treatment group received oral Jinshuibao Capsule therapy, hydration therapy and conventional treatment. The simple hydration therapy group received hydration therapy and conventional treatment. And the control group received conventional treatment alone.The dynamic change in serum creatinine （Scr） and blood urea nitrogen （BUN） at baseline and at 1,3 and 7d after the procedure in the three groups were compared.Results：In the control group and the simple hydration therapy group,the Scr levels significantly increased from baseline at 1d after the procedure,peaked on day 3 and then declined to baseline level at 7d after the procedure （ P〈0. 05 ） . The post-procedural Scr level in the combination treatment group did not show a similar trend of increasing and falling,and was comparable with the baseline （P〉0.05）.Compared with baseline,the BUN levels in the control group and simple hydration therapy group steadily increased after procedure（P〈0.05）.The BUN levels at different time points after procedure in the combination treatment group were comparable with baseline （P〉0.05）.The incidence rates of contrast-induced＆amp;nbsp;nephropathy in the combination treatment group,simple hydration therapy group and control group were 2.5%,5. 0% and 20. 0% respectively （ P〈0. 05 ） . Conclusion：For patients with renal insufficiency undergoing coronary angiography ,Jinshuibao Capsules combined with hydration therapy can prevent contrast-induced nephropathy more effectively than simple hydration therapy.