冠脉介入治疗围手术期使用保肾片防治造影剂肾病的临床研究

Clinical Study on Prevention and Treatment of Contrast-Induced Nephropathy with Baoshen Tablets in Perioperative Period of Coronary Intervention

目的观察保肾片预防冠脉介入治疗术后造影剂肾病的效果及可能机制。方法随机将80例接受冠脉介入治疗术的患者分为2组,对照组给予冠心病标准基础治疗;治疗组在对照组基础上,给予保肾片4片/次,每日3次,连服7d。观察术前、术后24h及术后72h血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)、肾小球滤过率(eGFR)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿β-半乳糖苷酶水平(GAL)水平。结果 2组间同时间点对比显示:治疗组与对照组术前各项肾损伤标志物水平无明显差异;术后24h治疗组CysC水平则低于对照组(P<0.05);术后72h治疗组Scr、BUN、CysC、NAG、GAL水平均低于对照组(P<0.05),而治疗组eGFR水平则明显高于对照组(P<0.05)。同一组内不同时间点对比显示:对照组术后24hCysC水平高于术前(P<0.05);治疗组术后72hScr、BUN、NAG、GAL水平均低于术前(P<0.05),eGFR水平则高于术前(P<0.05);对照组术后72hScr、BUN、CysC、NAG、GAL水平均高于术前(P<0.05),eGFR水平低于术前(P<0.05)。结论在冠脉造影围手术期的病人应用保肾片,对造影剂肾病具有较好的防治作用。

OBJECTIVE To observe the effect and mechanism of Baoshen Tablets in preventing contrast induced nephropathy after coronary intervention.METHODS 80 patients with coronary intervention were randomly divided into experimental group and control group.The control group was treated with standard basic treatment of coronary disease.The experimental group was given Baoshen Tablets,4 tablets/time,3 times a day on the basis of the control group.The serum creatinine(Scr),urea nitrogen(BUN),cystatin C(CysC),glomerular filtration(eGFR),urinary N acetylβglucosaminidase(NAG)and urinaryβgalactosidase level(GAL)levels were observed before surgery,24 h and 72 h after surgery.RESULTS The comparison of the two groups in the same time showed that there was no significant difference in the levels of kidney injury markers before operation.After 24 h of operation,the level of CysC in experimental group was lower than that in control group(P<0.05).After 72 h of operation,the Scr,BUN,CysC,NAG,GAL in experimental group were lower than those in control group,while eGFR in experimental group was significantly higher than that in control group(P<0.05).The comparison of the same group in different time showed that CysC in control group after 24 h of operation was higher than the preoperative level(P<0.05).After 72 h of operation,the level of Scr,BUN,NAG,GAL were lower than the preoperative level(P<0.05),while eGFR was higher than the preoperative leve in experimental group(P<0.05).In control group,after 72 h of operation,the levels of Scr,BUN,CysC,NAG and GAL were higher than the preoperative level(P<0.05),and eGFR was lower than the preoperative level(P<0.05).CONCLUSION Baoshen Tablets can prevent and treat contrast induced nephropathy for patients with the perioperative period of coronary intervention.