肾康注射液对外周动脉介入术后造影剂肾病的防治作用

Effect of Shenkang Injection inthe Prevention and Treatment of Contrast-induced Nephropathy after Peripheral Vascular Intervention

目的探讨中药制剂肾康注射液对外周动脉介入术后造影剂肾病(Contrast-induced nephropathy,CIN)防治的安全性和有效性。方法选取2020年1月—2021年5月期间中国中医科学院望京医院血管外科收治的下肢动脉硬化性闭塞症患者60例,按照随机数字表法分为对照组和试验组,每组各30例。对照组予常规的水化治疗,试验组予中药肾康注射液联合常规水化治疗。常规水化治疗方案:两组患者均于术前12 h至术后12 h应用生理盐水治疗。试验组在水化基础上于术前12 h、术后12 h给予中药肾康注射液静脉滴注。两组患者分别于术前、术后观察比较肌酐(Creatinine,Cr)、尿素氮(Blood urea nitrogen,BUN)、肾小球滤过率(Glomerular filtration rate,GFR)数值变化及造影剂肾病(Contrast-induced nephropathy,CIN)的发生率。结果术后,对照组CIN者5例,发生率为16.67%(5/30);试验组CIN者1例,发生率为3.33%(1/30)。两组患者CIN发生率比较,差异有统计学意义(P<0.05)。术后72 h两组患者Cr、BUN及GFR水平均较术前升高,差异有统计学意义(P<0.05);且试验组Cr、GFR水平均优于对照组,差异有统计学意义(P<0.05),BUN水平变化不明显,差异无统计学意义(P>0.05)。结论肾康注射液联合水化治疗对外周动脉介入术后CIN的发生具有一定的预防作用,其疗效优于单纯水化治疗。

Objective To explore the safety and effectiveness of Shenkang Injection for contrast-induced nephropathy(CIN)in patients after peripheral vascular intervention(PVI).Methods A total of 60 patients with arteriosclerosis obliterans of the lower limbswho were treated in the Department of Vascular Surgery,Wangjing Hospital,China Academy of Chinese Medical Sciences from January 2020 to May 2021 were randomized into the control group and the experimental group according to the random number table method,with 30 cases in either group.The control group was given conventional hydration treatment,while the experimental group was given Shenkang Injection combined with conventional hydration treatment.The conventional hydration treatment plan was to give normal saline to the two groups from 12 hours before operation to 12 hours after operation.On the basis of hydration,the experimental group was given intravenous infusion of Shenkang injection at 12 hours before operation and 12 hours after operation.Creatinine(Cr),Blood urea nitrogen(BUN),glomerular filtration rate(GFR)and the incidence of contrast medium nephropathy(CIN)were compared before and after operation.Results CIN occurred to 5 patients(16.67%,5/30)in the control group and 1 patient(3.33%,1/30)in the experimental group(P<0.05).The levels of Cr,BUN,and GFR were higher at 72 hours after operation than those before operation(P<0.05).After operation,levels of Crand GFR higher in the experimental group than those in the control group(P<0.05)and the level of BUN showed no significant difference between the two groups(P>0.05).Conclusion The combination of hydration therapy and SI has preventive effect on CIN in patients with PVI,and the effect is better than that of conventional hydration therapy alone.