金水宝胶囊联合前列地尔对冠状动脉介入治疗术后造影剂肾病的影响

Effect of Jinshuibao capsule combined with alprostadil on contrast-induced nephropathy after percutaneous coronary intervention

目的探讨金水宝胶囊联合前列地尔对冠状动脉介入治疗(PCI)术后造影剂肾病(CIN)的影响。方法选择2010年1月至2015年12月来我院接受PCI术的急性冠状动脉综合征(ACS)患者200例。按照随机数字表法分为金水宝胶囊联合前列地尔组(治疗组,100例)和前列地尔组(对照组,100例)。比较两组患者临床特征和治疗96 h后实验室指标的差异。应用单因素、多因素非条件Logistic回归分析进行ACS患者经PCI术后CIN发生的危险因素分析。结果两组患者临床特征比较差异无统计学意义(P>0.05)。PCI术后96 h,治疗组C反应蛋白、IL-6、血清尿酸、血浆Hcy、β2微球蛋白水平显著低于对照组(P<0.05);肌酐清除率、e GRF显著高于对照组(P<0.05);尿素氮、血清肌酐比较差异无统计学意义(P>0.05)。治疗组PCI术后发生12例CIN(12%),对照组25例(25%),两组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,术前血浆Hcy水平过高、前列地尔单独使用、有糖尿病病史的ACS患者PCI术后易发生CIN(P<0.05)。结论金水宝胶囊联合前列地尔对ACS患者PCI术后CIN的发生有一定益处,临床医师应密切注意ACS患者术前血浆Hcy水平和有无糖尿病病史。

Objective To investigate the effect of Jinshuibao capsule combined with alprostadil on contrast-induced nephropathy（ CIN） after percutaneous coronary intervention（ PCI）. Methods Totally 200 patients with acute coronary syndrome undergoing PCI in our hospital from January 2010 to Deccember 2015 were selected and divided into Jinshui capsule ＋ alprostadil group（ treatment group,n = 100） and alprostadil group（ control group,n = 100） according to the random number table method. The clinical features of the two groups and the difference in laboratory indexes at 96 h after treatment were compared. Univariate and multivariate unconditional Logistic regression analysis was used to analyze the risk factors for CIN in patients with ACS after PCI. Results There was no significant difference in clinical features between the two groups（ P〈0. 05）. At 96 h after PCI,the levels of C-reactive protein,IL-6,serum uric acid,plasma Hcy and beta 2 microglobulin in treatment group were significantly lower than those of control group（ P〈0. 05）; the creatinine clearance rate and e GRF were significantly higher than those of control group（ P〈0. 05）; there was no significant difference in urea nitrogen and serum creatinine between the two groups（ P〈0. 05）. There were 12 cases of CIN（ 12%） in treatment group and 25 cases in control group（ 25%）,the difference between the two groups being statistically significant（ P〈0. 05）. Multivariate Logistic regression analysis showed that PCI occurred in ACS,patients with high preoperative plasma Hcy level,alprostadil alone and the history of diabetes mellitus（ P〈0. 05）.Conclusion Jinshuibao capsule combined with alprostadil has certain benefit to the occurrence of CIN after PCI in patients with ACS; clinicians should pay close attention to the preoperative plasma Hcy level and the history of diabetes mellitus.