消瘀泄浊饮内服联合水化疗法预防经皮冠状动脉介入术后造影剂肾病的临床研究

Clinical study on the prevention of contrast induced nephropathy after PCI by the combination of Xiaoyu Xiezhuo Decoction and hydration therapy

目的:通过对比消瘀泄浊饮内服联合水化疗法和单纯水化疗法对PCI术患者肾脏的保护作用及造影剂肾病(CIN)的发生率的改变,确定联合疗法对CIN的预防作用。方法:选取PCI术患者300例,采用随机数字表法将其随机分为治疗组和对照组各150例,对照组患者在PCI术前12h采用常规水化疗法,治疗组患者在常规水化疗法的基础上加服消瘀泄浊饮。记录两组患者治疗前后肾功能指标(SCr、BUN、eGFR)、血清NGAL、CIN及不良事件的发生率。结果:术后治疗组SCr和BUN的升高差值及eGFR和NGAL的降低差值均显著高于对照组(P<0.05)。治疗组PCI术后CIN的发生率及肾脏透析率均显著低于对照组(P<0.05)。结论:消瘀泄浊饮内服联合水化疗法可有效预防CIN的发生,较单纯的水化疗法更具肾脏保护作用。

Objective:To determine the preventive effect of combination therapy on contrast induced nephropathy(CIN)by comparing the protective effect of Xiaoyu Xiezhuo Decoction combined with hydration therapy and simple hydration therapy on patients with PCI and the change of CIN.Methods:A total of 300 PCI patients were selected,150 patients were randomly divided into the treatment group and the control group by random number table method.The patients in the control group were treated with conventional hydration therapy during the perioperative period.The patients in the treatment group were given Xiaoyu Xiezhuo Decoction based on conventional hydration therapy.The renal function indexes(SCr,BUN,eGFR),serum NGAL,CIN and adverse events were recorded before and after treatment.Results:The difference between the increase of SCr and BUN and the decrease of eGFR and NGAL in the postoperative treatment group were significantly higher than the corresponding difference of the control group(P<0.05).The incidence of CIN and renal dialysis rate in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Xiaoyu Xiezhuo Decoction combined hydration therapy can effectively prevent the occurrence of CIN,and it has more kidney protection than simple hydration therapy.