前列腺素E1联合水化在PCI中的应用及对血肌酐和炎症反应的影响

Application of prostaglandin-E1(PG-E1) combined with hydration in PCI and its influence on serum creatinine and inflammatory reactions

目的研究前列腺素E1联合水化在经皮冠状动脉介入(PCI)术中的应用及对血肌酐和炎症反应的影响。方法选择2015年8月~2017年6月于东南大学附属中大医院江北院区(南京市大厂医院)行PCI治疗的冠状动脉粥样硬化性心脏病(冠心病)患者68例,根据治疗情况分为观察组及对照组,每组各34例,对照组中男性19例,女性15例,采用水化法治疗;观察组中男性18例,女性16例,在对照组基础上联合前列腺素E1治疗。结果治疗后观察组肱动脉血流介导性舒张功能(FMD)、一氧化氮(NO)水平显著高于对照组,差异有统计学意义(P<0.05),观察组血清内皮素(ET-1)、高敏C反应蛋白(hs-CRP)水平显著低于对照组,差异有统计学意义(P<0.05);治疗后观察组患者发生心绞痛、心力衰竭、主要心血管事件、支架内再狭窄率均明显低于对照组(P<0.05),观察组急性心肌梗死、心源性猝死发生率较对照组无明显差异(P>0.05);观察组PCI术后血清内生肌酐(Scr)值较对照组明显降低,且内生肌酐清除率(Ccr)值较对照组明显上升,差异有统计学意义(P<0.05)。结论前列腺素E1联合水化治疗行PCI术患者,可显著减少炎症反应,降低血清肌酐水平,显著降低心血管事件发生率。

Objective To study the application of prostaglandin-E1(PG-E1)combined with hydration in percutaneous coronary intervention(PCI)and its influence on serum creatinine(SCr)and inflammatory reactions.Methods The patients with coronary heart disease(CHD,n=68)undergone PCI were chosen from Jiangbei Area of Zhongda Hospital of Southeast University from Aug.2015to June2017,and divided,according to treatment status,into observation group and control group(each n=34).The control group(male=19and female15)were given hydration therapy,and observation group(male=18and female16)was given PG-E1combined with hydration therapy.Results The levels of brachial artery flow-mediated dilation(FMD)and nitric oxide(NO)were significantly higher in observation group than those in control group after treatment(P<0.05).The levels of endothelin(ET)and high-sensitivity C-reactive protein(hs-CRP)were significantly lower in observation group than those in control group after treatment(P<0.05).The incidence of angina pectoris,heart failure,major adverse cardiovascular events(MACE)and in-stent restenosis were all significantly lower in observation group than those in control group after treatment(P<0.05).The incidence of acute myocardial infarction(AMI)and sudden cardiac death had no significant difference between2groups(P>0.05).The value of SCr decreased significantly,and value of endogenous creatinine clearance rate(Ccr)increased significantly in observation group compared with control group after PCI(P<0.05).Conclusion The therapy of PG-E1combined with hydration can reduce inflammatory reactions,SCr level and incidence of MACE in CHD patients undergone PCI.