乌司他丁联合大剂量阿托伐他汀对冠心病合并糖尿病患者PCI术后肾功能的影响

Effect of Ulinastatin Combined with High Dose Atorvastatin on Renal Function in Patients with Coronary Heart Disease and Diabetes Mellitus After PCI

目的探讨乌司他丁联合大剂量阿托伐他汀对冠心病合并糖尿病患者经皮冠状动脉介入术(PCI)术后肾功能的影响。方法选取于2018年6月-2019年6月间在南阳市第一人民医院进行PCI治疗的128例冠心病合并糖尿病患者,将2018年入院患者作为对照组(64例),2019年入院患者作为观察组(64例)。对照组使用阿托伐他汀治疗,观察组使用乌司他丁联合大剂量阿托伐他汀治疗。比较两组对比剂肾病发病率,肾功能指标及生化指标。结果观察组肾病发病率低于对照组(P<0.05),术前两组肾功能指标差异无统计学意义(P>0.05)。术后3 d观察组血尿素氮(BUN)、血清肌酐(Scr)低于对照组(P<0.05),肾小球滤过率(eGFR)高于对照组(P<0.05)。术前两组炎症因子水平差异无统计学意义(P>0.05),术后3 d观察组血清肿瘤坏死因子-α(TNF-α)及IL-6水平低于对照组(P<0.05)。结论乌司他丁联合大剂量阿托伐他汀可有效降低冠心病合并糖尿病患者PCI术后肾病发病率,改善其肾功能并减轻炎症反应,有助于促进患者术后病情康复,值得推荐。

Objective To investigate the effect of ulinastatin combined with high dose atorvastatin on renal function in patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention(PCI).Methods 128 patients with coronary heart disease and diabetes underwent PCI in the hospital from June,2018 to June,2019 were enrolled,and divided into two groups according to the admission years,with 64 cases in each group.The control group received atorvastatin,while the observation group received ulinastatin combined with high-dose atorvastatin.The incidence of nephropathy,renal function index and biochemical index were observed and compared.Results The incidence of nephropathy in the observation group was lower than that in the control group(P<0.05).There was no significant difference in renal function indexes between the two groups before operation(P>0.05).On postoperative 3 d,BUN and Scr levels in the observation group were lower than those in the control group(P<0.05),and eGFR was higher than that in the control group(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before surgery(P>0.05).The serum TNF-αand IL-6 levels in the observation group were lower than those in the control group at postoperative 3 d(P<0.05).Conclusion Ulinastatin combined with high dose atorvastatin can effectively reduce the incidence of nephropathy in patients with coronary heart disease complicated with diabetes after PCI,improve renal function,reduce inflammatory response,and promote postoperative recovery,which is worth recommendation.