非布司他联合水化对伴有高尿酸的冠心病患者造影剂肾病的预防作用

Preventive effect of febuxostat combined with hydration on contrast-induced nephropathy in patients with coronary heart disease complicated with hyperuricemia

目的探讨非布司他联合水化对冠心病伴有高尿酸患者造影剂肾病的预防作用。方法选择2019年1月至2020年6月在河南大学第一附属医院择期行冠状动脉造影(CAG)或冠状动脉支架植入(PCI)的冠心病患者,根据治疗方法分为非布司他联合水化组(n=100)和单纯水化组(n=102)。比较术后48 h造影剂肾病的发生率,对比术前和术后6 h中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及术后48 h血肌酐、肾小球滤过率(eGFR)、血尿酸水平。结果非布司他联合水化组造影剂肾病的发生率(6.0%)低于单纯水化组(14.71%),差异有统计学意义(P<0.05)。非布司他联合水化组术后6 h的NGAL及术后48 h的血肌酐、血尿酸低于单纯水化组,eGFR的水平高于单纯水化组,差异均有统计学意义(P<0.05)。结论非布司他联合水化可减少伴有高尿酸血症的冠心病患者造影剂肾病的发病率。

Objective To investigate the preventive effect of febuxostat combined with hydration on contrast-induced nephropathy in coronary heart disease patients with hyperuricemia.Methods Patients with coronary artery disease with hyperuricemia receiving selective coronary angiography or coronary stent implantation in the our hospital from January 2019 to June 2020 were divided into febuxostat combined hydration group(n=100)and simple hydration group(n=102)according to the treatment.The incidence of contrast-induced nephropathy at 48 hours after operation was compared between the two groups;preoperative and postoperative 6-hour levels of neutrophil gelatinase-associated lipocalin(NGAL)and 48-hour levels of serum creatinine,serum uric acid and estimated glomerular filtration rate(eGFR)were measured in the two groups.Results The incidence of contrast-induced nephropathy in febuxostat-combined-hydration group(6.0%)was lower than that in simple hydration group(14.71%),and the difference was statistically significant(P<0.05).The 6-hour levels of NGAL and the 48-hour levels of serum creatinine and serum uric acid in febuxostat-combined-hydration group were lower than those in simple hydration group after operation,and the level of eGFR was higher than that in simple hydration group(P<0.05).Conclusion Febuxostat combined with hydration can reduce the incidence of contrast-induced nephropathy in patients with coronary heart disease complicated with hyperuricemia.