尼可地尔联合水化对伴有肾功能不全的冠心病患者造影剂肾病的预防作用

Preventive Effect of Nicorandil Combined with Hydration on Contrast-Induced Nephropathy in Patients with Coronary Heart Disease with Renal Insufficiency

目的探讨尼可地尔联合水化对伴有肾功能不全的冠心病患者造影剂肾病的预防作用。方法选取于河南大学第一附属医院2017年10月至2019年7月行择期冠状动脉造影术或冠状动脉支架植入术的肾功能不全的冠心病患者,将入组患者按照治疗方法分为尼可地尔联合水化组(63例)和单纯水化组(66例)。比较两组术后48 h造影剂肾病的发生率,测定两组术前和术后48 h血肌酐、胱抑素C、肾小球滤过率(eGFR)水平。结果尼可地尔联合水化组造影剂肾病的发生率(9.50%)低于单纯水化组(22.73%),差异有统计学意义(P<0.05)。尼可地尔联合水化组术后48 h肌酐及胱抑素C水平低于单纯水化组,eGFR水平高于单纯水化组,差异有统计学意义(均P<0.05)。结论尼可地尔联合水化可降低伴有肾功能不全的冠心病患者造影剂肾病的发生率。

Objective To investigate the preventive effect of nicorandil combined with hydration on contrast-induced nephropathy in patients with coronary heart disease with renal insufficiency.Methods Patients with coronary artery disease with renal insufficiency performed in selective coronary angiography or coronary stent implantation in the First Affiliated Hospital of Henan University from October 2017 to July 2019 were divided into nicorandil combined hydration group(63 cases) and simple hydration group(66 cases) according to the treatment. The incidence of postoperative 48-hour contrast-induced nephropathy in the two groups was compared, and preoperative and postoperative 48-hour levels of serum creatinine, cystatin C, and glomerular filtration rate(eGFR) were measured in the two groups.Results The incidence of contrast-induced nephropathy in nicorandil combined hydration group(9.50%) was lower than that in simple hydration group(22.73%), and the difference was statistically significant(P<0.05). The levels of creatinine and cystatin C in nicorandil combined hydration group were lower than those in simple hydration group 48-hour after operation, and the level of eGFR was higher than that in simple hydration group(all P<0.05).Conclusion Nicorandil combined with hydration could reduce the incidence of contrast-induced nephropathy in patients with coronary heart disease with renal insufficiency.