丹参酮ⅡA注射液对冠状动脉造影患者造影剂肾病及血清microRNAs表达的影响

Effect of Tanshinone ⅡA Injection on Contrast Nephropathy and Expression of Serum MicroRNAs in Patients Undergoing Coronary Angiography

目的研究丹参酮ⅡA注射液对冠状动脉造影患者造影剂肾病及血清微小RNAs(microRNAs,miRs)表达的影响。方法选取2020年3月—2022年3月期间在潍坊市人民医院进行冠状动脉造影检查的110例患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各55例。对照组接受标准基础治疗,观察组在标准基础治疗的基础上给予丹参酮ⅡA注射液治疗。治疗6 d后,观察比较两组患者血肌酐(Serum creatinine,Scr)、血尿素氮(Blood urea nitrogen,BUN)、中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil gelatinase-associated lipocalin,NGAL)、胱抑素C(Cystatin C,CysC)、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)及miR-376b、miR-30b、miR-223、miR-145、miR-133表达水平,评价术后72 h造影剂肾病的发生率,分析肾功能指标与miRs表达的相关性。结果观察组术后72 h的造影剂肾病发生率低于对照组,差异有统计学意义(P<0.05)。术后24 h、72 h观察组Scr、BUN、CysC、NGAL水平较术前升高,但差异无统计学意义(P>0.05),血清miR-376b、miR-30b、miR-223表达水平较术前升高,血清miR-145、miR-133表达水平较术前降低,差异有统计学意义(P<0.05);术后24 h、72 h对照组Scr、BUN、CysC、NGAL水平较术前升高,差异有统计学意义(P<0.05);观察组术后24 h、72 h Scr、BUN、CysC、NGAL水平及血清miR-145、miR-133表达水平低于对照组,血清miR-376b、miR-30b、miR-223表达水平高于对照组,差异有统计学意义(P<0.05)。两组患者术后24 h、72 h ALT、AST水平与术前比较及观察组术后24 h、72 h ALT、AST水平与对照组比较,差异均无统计学意义(P>0.05)。术后24 h及72 h时,Scr、BUN、CysC、NGAL水平与血清miR-376b、miR-30b、miR-223表达水平呈负相关,与miR-145、miR-133表达水平呈正相关。结论丹参酮ⅡA注射液对冠状动脉造影患者的术后肾功能及miRs表达均具有改善作用,进而能够对造影剂肾病起到防治作用。

Objective To study the effect of tanshinone ⅡA injection on contrast nephropathy and the expression of serum microRNAs(miRs)in patients undergoing coronary angiography.Methods A total of 110 patients who underwent coronary angiography in Weifang People's Hospital from March 2020 to March 2022 were randomly divided into an observation group and a control group by digital table method,with 55 cases in each group.The control group received standard basic treatment,and the observation group was treated with tanshinone ⅡA injection for six days on the basis of standard basic treatment.The levels of serum creatinine(Scr),blood urea nitrogen(BUN),neutrophil gelatinase-associated lipocalin(NGAL),cystatin C(CysC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and the expression levels of miR-376b,miR-30b,miR-223,miR-145,and miR-133 in the two groups were detected.The incidence of contrast nephropathy 72 hours after the operation was evaluated.The correlation between renal function indexes and miR expression was analyzed.Results The incidence of contrast nephropathy in the observation group was lower than that in the control group 72 hours after operation(P<0.05).24 hours and 72 hours after the operation,the levels of Scr,BUN,CysC,and NGAL of the observation group were higher than those before the operation,but there was no statistical significance(P>0.05).The expression levels of serum miR-376b,miR-30b,and miR-223 were higher than those before the operation,while those of serum miR-145 and miR-133 were lower than those before the operation.The difference was statistically significant(P<0.05);24 hours and 72 hours after the operation,the levels of Scr,BUN,CysC,and NGAL of control were higher than those before the operation,and the difference was statistically significant(P<0.05);24 hours and 72 hours after the operation,the levels of Scr,BUN,CysC,and NGAL,as well as the expression levels of miR-145 and miR-133 of observation group were lower than those of the control group,and the expression levels of serum miR-376b,miR-30b,and miR-223 were higher than those of the control group.The difference was statistically significant(P<0.05).There was no significant difference in ALT and AST levels between the two groups 24 h and 72 h after operation and between the observation group 24 h and 72 h after operation and the control group(P>0.05).24h and 72h after operation,the levels of Scr,BUN,CysC,and NGAL were negatively correlated with the expression levels of serum miR-376b,miR-30b,and miR-223 and positively correlated with the expression levels of miR-145 and miR-133.Conclusion Tanshinone ⅡA injection improves the renal function and the expression of miRs in patients after coronary angiography and can prevent and treat contrast nephropathy.