前列地尔联合丹参多酚酸盐对PCI术后对比剂肾病的预防作用

Effects of the alprostadil combined with salvianolate on renal function in patients who received PCI

目的探讨前列地尔联合丹参多酚酸盐对经皮冠状动脉介入治疗(PCI)患者术后对比剂肾病的预防作用。方法将择期行PCI患者282例,随机分为常规水化组(A组,94例)、前列地尔+水化组(B组,94例)、前列地尔联合丹参多酚酸盐+水化组(C组,94例),分别测定并比较各组间患者术前、术后24 h、72 h尿素氮(BUN)、血清β2微球蛋白、血肌酐(Scr)水平及对比剂肾病(CIN)的发生率。结果术后24 h与术前相比,A、B两组BUN、血清β2微球蛋白、Scr水平均显著升高(P<0.05),C组BUN、血清β2微球蛋白轻度升高(P<0.05),Scr升高不显著(P>0.05);术后72 h各组BUN、血清β2微球蛋白、Scr均恢复至术前水平(P>0.05);A组CIN发生率为13.8%,B组为9.6%,C组为3.2%,B组与A组比较差异无统计学意义(P>0.05),C组与A组比较差异有统计学意义(P<0.05)。结论前列地尔联合丹参多酚酸盐+水化疗法对PCI术后对比剂肾病具有一定的预防作用。

Objective To investigate the effect of alprostadil combined with salvianolate on renal function after percutaneous coronary intervention (PCI). Methods 282 patients received PCI were randomly divided into three groups, hydration saline group (group A), alprostadil + hydration group (group B), alprostadil joint salvianolate + hydration group (group C). The levels of serum urea nitrogen (BUN), serum β2 - microglobulin, serum creatinine(Scr) and the incidence of contrast - induced nephropathy (CIN) were measured and compared before operation, 24 h and 72 h after operation. Results The levels of BUN, serum β2-microglobulin and Scr in group A and B were significantly higher than those before operation (P<0.05). The levels of BUN and serum β2 microglobulin in group C were slightly higher than those before operation (P<0.05), and the increase of Scr was not significant (P>0.05).There was no significant difference in BUN and serum β2-microglobulin and Scr between the two groups at 72 h after operation (P>0.05). The incidence of CIN was 13.8% in group A, 9.6% in group B and 3.2% in group C,and there was no significant difference between group B and group A (P>0.05). There was a significant difference between group C and group A (P<0.05). Conclusion The combination of alprostadil and salvia miltiorrhiza phenolic acid + hydration therapy has a certain preventive effect on the contrast agent nephropathy after PCI.