别嘌醇对高尿酸血症患者经皮冠状动脉介入治疗术后对比剂肾病发生情况的影响

Effects of Allopurinol on Contrast-Induced Nephropathy Among Patients with Hyperuricemia After Percutaneous Coronary Intervention

目的:探讨别嘌醇对高尿酸血症患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后对比剂肾病发生情况的影响。方法:将拟行PCI术的高尿酸血症患者152例以随机数字表法分为观察组(75例)和对照组(77例),观察组患者于PCI术前24 h内口服别嘌醇300 mg,对照组患者不服用别嘌醇。观察两组患者术前和术后24、48 h的血清肌酐(Scr)、尿酸及肾小球滤过率(GFR)水平,对比剂肾病发生情况。结果:PCI术后24 h,观察组患者的尿酸水平明显低于对照组;PCI术后48 h,观察组患者的Scr、尿酸水平明显低于对照组,GFR水平明显高于对照组,上述差异均有极显著统计学意义(P<0.01)。住院期间,观察组患者对比剂肾病发生率为5.33%(4/75),明显低于对照组的15.58%(12/77),差异有统计学意义(P<0.05)。结论:别嘌醇可以降低高尿酸血症患者PCI术后对比剂肾病的发生率,减轻对比剂引起的肾损伤。

OBJECTIVE： To probe into the effects of allopurinol on contrast-induced nephropathy among patients with hyperuricemia after percutaneous coronary intervention（ PCI）. METHODS： 152 patients with hyperuricemia undergoing PCI were divided into observation group（ 75 cases） and control group（ 77 cases） via random number table,the observation group was given 300 mg of allopurinol orally at 24 hours before PCI,while the control group was given no medication. Levels of serum creatinine（ Scr）,uric acid（ UA） and glomerular filtration rate（ GFR） of both groups before operation, at 24 hours and 48 hours after were monitored, the incidences of contrast-induced nephropathy of two groups were observed. RESULTS： At 24 hours after PCI,the UA level of observation group was significantly lower than that of the control group; at 48 hours after PCI,the Scr level and UA level of observation group were significantly that those of the control group,with significantly higher GFR level,the differences had extremely statistical significances（ P〈0. 01）. During hospital stays, the incidence of contrast-induced nephropathy of observation group（ 5. 33%,4/75） was significantly lower than that of the control group（ 15. 58%,12/77）,with statistically significant difference. CONCLUSIONS： Allopurinol can reduce the incidence of contrast-induced nephropathy among patients with hyperuricemia after PCI,and relieve renal damage caused by contrast agents.