血府逐瘀汤对冠状动脉介入术后对比剂肾病的防治作用

Xuefuzhuyu Decoction on contrast induced nephropathy after percutaneous coronary intervention

目的应用血府逐瘀汤对冠状动脉介入术围手术期患者干预,观察该药物对于对比剂肾病的防治作用。方法纳入我院住院并行经皮冠状动脉介入术(PCI)患者240例,随机分为常规治疗组(n=120)和血府逐瘀汤干预组(n=120),两组在PCI术前、术后常规给予抗血小板、调脂及水化治疗,且均不禁食、禁水;血府逐瘀汤干预组在此基础上,于PCI前3天和术后3天加用血府逐瘀汤干预,每天1次;检测两组PCI前后血清肌酐(Scr)、肾小球滤过率估测值(eGFR)及超氧化物歧化酶(SOD)、丙二醛(MDA)的变化。结果血府逐瘀汤干预组Scr、eGFR的变化显著小于常规治疗组(P<0.01);MDA含量显著低于常规治疗组(P<0.05)、SOD明显高于常规治疗组(P<0.05)。结论PCI围手术期使用血府逐瘀汤有助于减少对比剂肾病的发生,其机制可能与血府逐瘀汤清除氧自由基和降低对比剂的黏滞性有关。

Objective To investigate the protective effect of Xuefuzhuyu Decoctionin patients with contrast agent nephropathy after percutaneous coronary intervention(PCI).Methods A total of 240 patients was enrolled and randomly divided into two groups:Control group(n =120)and Observation group(n =120).Before and after PCI,all the patients were routinely given anti-platelets,lipid regulation,hydration therapy,and were not fasting.Based on the routine therapy,observation group was given Xuefuzhuyu Decoctiononce a day before 3 days PCI and after 3 days of PCI.Serum creatinine(SCr),estimated glomerular filtration rate(eGFR),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured respectively before and after PCI.Results Compared with Control group,observation group presented a lower fluctuation of SCr and eGFR(P <0.01) Moreover, MDA content was significantly lower than that in the conventional group(P <0.05)and SOD was significantly higher than that in the conventional group(P <0.05).Conclusion The medication of Xuefuzhuyu Decoction before and after PCI may effectively reduce the incidence of contrast agent nephropathy.The mechanism may be related to the removal of oxygen radicals and the decrease of contrast agent viscosity.