黄芪注射液对慢性肾脏病患者对比剂暴露后肾功能的影响

Effect of Astragalus Injection on Renal Function after Exposure to Contrast Medium in Patients with Chronic Kidney Disease

目的研究黄芪注射液对慢性肾脏病患者对比剂暴露后肾功能的影响。方法选取进行各种造影检查的慢性肾脏病3期患者80例,按随机数字表法分为黄芪注射液组(治疗组)和生理盐水对照组(对照组),每组40例。对比剂采用低渗的非离子型对比剂碘海醇,剂量最大不超过100mL。从造影前6h至造影后12h,采用黄芪注射液(药物配比为40mL黄芪注射液配500mL的生理盐水)以0.5mL·h-1·kg-1的速度静脉滴注,对照组则以0.5mL·h-1·kg-1速度静脉滴注生理盐水。抽取造影当日及造影后第3、7天的清晨空腹血,检测血肌酐水平,并比较2组对比剂肾病(CIN)的发病率。结果造影后3、7d,2组血肌酐水平差异无统计学意义(P>0.05),与基线水平的差值治疗组明显低于对照组[(6.18±2.37)μmol·L-1比(9.36±3.32)μmol·L-1;(2.12±1.13)μmol·L-1比(3.76±1.96)μmol·L-1,均P<0.01]。2组造影后3d和7d的CIN发病率比较差异无统计学意义(P>0.05)。结论黄芪注射液可明显降低慢性肾脏病患者对比剂暴露后血肌酐升高的幅度,对慢性肾脏病对比剂暴露后的肾损伤有一定的防护作用。

Objective To study the effects of Astragalus injection on renal function in patients with chronic kidney disease(CKD)after exposure to contrast agent.Methods From6hours before exposure to12hours after exposure to hypotonic nonionic iohexol,80patients with stage3CKD were treated with either Astragalus injection(40mL in500mL normal saline,treatment group,n=40)or normal saline(control group,n=40)by intravenous infusion at the speed of0.5mL·h^-1·kg^-1.Fasting blood samples were collected to detect the level of serum creatinine on the day of contrast agent injection and the third and seventh days after contrast agent injection.In addition,the incidence of contrast-induced nephropathy(CIN)was compared between the two groups.Results On the third and seventh days after contrast agent injection,there were no significant differences in the level of serum creatinine and the incidence of CIN between the two groups(P>0.05),but the differences between serum creatinine level and baseline in treatment group were higher than those in control group((6.18±2.37)μmol·L^-1vs(9.36±3.32)μmol·L^-1and(2.12±1.13)μmol·L^-1vs(3.76±1.96)μmol·L^-1,respectively;P<0.01).Conclusion Astragalus injection can significantly inhibit the increase in serum creatinine in patients with CKD after exposure to contrast agent,suggesting a protective effect of Astragalus injection on renal injury following contrast agent exposure.