辅酶Q10注射液对冠心病患者介入治疗后对比剂肾病的影响

Effects of Coenzyme Q10 injection on preventing contrast-induced nephropathy in patients with coronary artery disease after percutaneous coronary intervention

目的研究辅酶Q10注射液对冠心病患者经皮冠状动脉介入治疗（PCI）后对比剂肾病（CIN）的影响。方法168例行冠状动脉介入治疗的患者被随机分为对照组（84例）和治疗组（84例）。两组均给予常规水化治疗，治疗组在此基础上于术前3d及术后连续3d予以辅酶Q10注射液10mg静脉滴注，每日1次。分别于术前及术后24h、48h测定两组患者血清肌酐（Scr）、肌酐清除率（Ccr）及中性粒细胞明胶相关载脂蛋白（NGAL）。结果168例患者中有13例（7．7％）发生对比剂肾病，其中对照组9例（10．7％）发生对比剂。肾病，治疗组4例（4．8％）发生对比剂。肾病，治疗组与对照组比较差异有统计学意义（P〈0．05）。术后48h治疗组及对照组Scr分别为（74．9±17．0）μmol／L和（80．9±22．5）μmol／L，均高于治疗前（69．2±12．3）μmol／L和（70．4±14．9）μmol／L；Ccr分别为（94．0±14．8）ml／min和（89．5±14．7）ml／min，均低于治疗前（101．3±14．9）m1／min和（99．5±16．2）ml／min，组间比较差异有统计学意义（P〈0．05）。治疗组术后24h、48h的NGAL分别为（32．80±45．09）ng／ml和（30．91±34．27）ng／ml，均低于对照组的（49．93±65．13）ng／ml和（42．95±44．07）ng／ml，差异有统计学意义（P〈0．05）。结论辅酶Q10注射液可降低PCI术后对比剂肾病的发生率。

Objective To study the effects of Coenzyme QlO injection on preventing contrast-induced nephropathy（CIN ） in patients with coronary artery disease after pereutaneous coronary intervention（PCI）. Methods 168 patients with coronary artery disease after percutaneous coronary intervention were randomly divided into 2 groups. the control group（84 cases）, the patients only accepted routine hydration treatment by intravenous of 0.9% sodium chloride solution. In the treating group （84 cases）, besides the hydration treatment, the patients also accepted in- travenous infusion of Coenzyme Q10 injection lO mg/day at 3 days before and 3 days after the operation respectively. The serum ereatinine （Ser）, the serum creatinine clearance rate （Ccr） and neutrophil gelatinase-associated lipocalin（NGAL） were detected before and 24 h,48 h after the operation. Results There were 13/168（7.7%） patients suffered from CIN, control group had 9/84 （10.7%） and treating group had 4/84 （4.8%）, the CIN occur- rence rate in control group was higher than that in treating group（P〈0.05）. Ser at 48 hours[ （74.9±17.0）μmol/L, （ 80.9±22.5 ）p, moi/L] after PCI was significantly higher in the two group than the pre-operative condition [（69.2± 12.3 ）μ mol/L, （ 70.4±14.9 ）μmol/L （P〈0.05） ]. Cer at 48 hours [ （94.0±14.8）ml/min, （89.5± 14.7 ）ml/min] after PCI was signifieantly lower in the two group than the pre-operative condition [ （101.3±14.9）ml/min, （99.5± 16.2）ml/min（P〈0.05）]. There was significant statistics difference between the two groups（P〈0.05）. NGAL at 24 hours and 48 hours [（32.80±45.09）ng/ml, （30.91±34.27）ng/ml] after PCI was significant lower in the treating group than the Control group E（49.93±65.13）ng/ml, （42.95±44.07）ng/ml（P〈0.05）l. There was significant statistics difference between the two groups（P〈0.05）. Conclusion Coenzyme QIO injection may reduce the risk of CIN occurrence at certain degree in patients after PCI.