摘要
目的:探讨前列地尔(前列腺素E1)联合水化治疗对老年冠心病患者行经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)的预防作用。方法:选择2011-03至2014-03我院收治的175例年龄>70岁冠心病行PCI术患者纳入本研究,男122例(9.71%),平均年龄(74.7±3.9)岁,随机数字法分为两组:对照组(n=84):在常规治疗基础上,术前6 h和术后12 h给予1 ml/(kg·h)生理盐水静脉滴注水化治疗;前列地尔联合水化组(n=91):在常规治疗、水化治疗基础上,于术前1天和术后第3天静脉滴注前列地尔10μg,溶于100 ml生理盐水,2次/d。两组患者于PCI术前及术后连续3天分别测定血清肌酐水平(SCr)并计算内生肌酐清除率(Ccr),观察两组CIN的发生率。结果:Scr水平:术后第3天前列地尔联合水化组与对照组同期比较降低[(92.08±21.65)mmol/L vs(99.43±22.77)μmol/L],差异有统计学意义(P<0.05)。Ccr:术后第3天前列地尔联合水化治疗组与对照组同期比较升高[(63.78±20.58)ml/min vs(57.09±22.31)ml/min],差异有统计学意义(P<0.05)。PCI术后CIN的发生率:前列地尔联合水化组3.3%(3例)较对照组13.1%(11例)降低,差异有统计学意义(P<0.05)。结论:对于老年冠心病行PCI者,前列地尔联合水化治疗可以明显改善患者术后肾功能,降低CIN的发生。
Objective: To investigate the preventive effect of alprostadil (prostaglandin E 1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71%) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg·h) at 6 hours prior and 12 hours after PCI, n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 101.tg in 100ml normal saline twice a day at 1 day prior PCI and the 3ra day after PCI, n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the C1N occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) gmol/L was lower than Control group (99.43 ±22.77) μmol/L, P〈0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ±20.58) ml/minwas higher than Control group (57.09 ± 22.31) ml/min, P〈0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients), P〈0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.
出处
《中国循环杂志》
CSCD
北大核心
2015年第9期841-844,共4页
Chinese Circulation Journal
关键词
对比剂肾病
水化治疗
前列地尔
Contrast-induced nephropathy
Hydration
Alprostadil