复方丹参滴丸对老年患者造影剂诱导的急性肾损伤的保护作用

Protective effect of Compound Danshen Dripping Pills on contrast-induced acute kidney injury in elderly patients

目的探讨复方丹参滴丸对老年患者造影剂诱导急性肾损伤(CIAKI)的保护作用。方法入选2021年1月至2022年2月于我院心内科拟行PCI的老年冠心病患者260例,随机分为对照组130例和复方丹参滴丸组130例。对照组给予水化治疗。复方丹参滴丸组除水化治疗外,口服复方丹参滴丸。观察肾功能指标:肌酐、尿素、估算肾小球滤过率(eGFR),炎性指标:白细胞介素6(IL-6)、高敏C反应蛋白(hs-CRP),氧化应激指标:丙二醛、超氧化物歧化酶(SOD)。结果与PCI术前比较,2组术后72 h肌酐、尿素、hs-CRP、IL-6、丙二醛明显升高,eGFR、SOD明显降低(P<0.05,P<0.01),复方丹参滴丸组术后72 h肌酐、尿素、IL-6、hs-CRP、丙二醛水平明显低于对照组,eGFR、SOD水平明显高于对照组(P<0.05,P<0.01)。复方丹参滴丸组CIAKI发病率明显低于对照组(3.08%vs 11.54%,P=0.015)。口服复方丹参滴丸对预防术后CIAKI有积极作用(OR=0.225,95%CI:0.700~0.724,P=0.012)。结论复方丹参滴丸对老年冠心病患者PCI术后CIAKI的发生可能具有一定预防效果。

Objective To investigate the protective effect of Compound Danshen Dripping Pills on contrast-induced acute kidney injury(CIAKI)in the elderly patients.Methods Two hundred and sixty elderly patients who were about to undergo PCI in Tianjin Chest Hospital from January 2021 to February 2022 were randomly divided into Compound Danshen Dripping Pills group(n=130)and control group(n=130).The patients in the control group received hydration therapy only,and those in the Compound Danshen Dripping Pills group were given Compound Danshen Dripping Pills except hydration therapy.The levels of renal function indexes(BUN,Scr and eGFR),inflammatory reaction indexes(IL-6 and CRP),and oxidative stress indexes(malondialdehyde and SOD)were measured.Results The levels of Scr,BUN,hs-CRP,IL-6 and malondialdehyde were significantly increased,while those of eGFR and SOD were obviously decreased in both groups in 72 h after PCI(P<0.05,P<0.01).In 72 h after PCI,the levels of Scr,BUN,hs-CRP,IL-6 and malondialdehyde were notably lower,and those of eGFR and SOD were remarkably higher in the Compound Danshen Dripping Pills group than the control group(P<0.05,P<0.01).The treatment group had statistically lower incidence of CIAKI than the control group(3.08%vs 11.54%,P=0.015).Compound Danshen Dripping Pills had positive effect on the prevention of CIAKI(OR=0.225,95%CI:0.700-0.724,P=0.012).Conclusion Compound Danshen Dripping Pills may exert certain preventive effect on the development of CIAKI in elderly patients with coronary heart disease after PCI.