左卡尼汀联合水化对冠心病伴肾功能不全患者介入术后并发造影剂肾病的预防作用

Effect of levocarnitine combined with hydration in the prevention of contrast induced nephropathy after interventional surgery in patients with coronary heart disease complicated by renal insufficiency

目的探究左卡尼汀(LC)联合水化对冠心病(CHD)伴肾功能不全患者介入术后并发造影剂肾病(CIN)的预防作用。方法分析性研究。抽取2021年1月至2022年1月于西安市中医医院行介入术治疗的CHD伴肾功能不全患者86例,按照随机数字表法分为对照组与观察组,每组43例。对照组给予水化治疗,观察组给予LC联合水化治疗。比较两组术后CIN发生率、不良事件发生率;比较两组手术前后肾功能指标[尿素氮(BUN)、血肌酐(Scr)、肌酐清除率(CCr)]。结果观察组CIN发生率(4.65%,2/43)低于对照组(18.60%,8/43),P<0.05。术后24、48 h,两组Scr、BUN水平均升高,但观察组Scr、BUN水平低于对照组(P<0.05);术后24、48 h,两组CCr下降,但观察组CCr高于对照组(P<0.05)。观察组不良事件发生率(2.33%,1/43)与对照组(6.88%,3/43)比较差异未见统计学意义(P>0.05)。结论LC联合水化应用于伴肾功能不全的CHD介入术患者中,能够降低CIN发生率,保护肾功能,有效预防CIN。

Objective To investigate the application value of levocarnitine(LC)combined with hydration in the prevention of contrast induced nephropathy(CIN)after interventional surgery in patients with coronary heart disease(CHD)complicated by renal insufficiency.Methods A total of 86 CHD patients with renal insufficiency treated by interventional surgery in Xi’an Hospital of Traditional Chinese Medicine from January 2021 to January 2022 were selected for the analytical study.And they were divided into the control group and the observation group by random number table method,with 43 cases in each group.The control group received hydration treatment,while the observation group received LC combined with hydration treatment.The incidence of postoperative CIN and adverse events were compared between the two groups.The renal function indicators,including blood urea nitrogen(BUN),serum creatinine(Scr)and creatinine clearance rate(CCr),were compared between the two groups before and after surgery.Results The incidence of CIN in the observation group(4.65%,2/43)was lower than that in the control group(18.60%,8/43),P<0.05.At 24 and 48 hours after surgery,the levels of Scr and BUN increased in both groups,but the observation group had lower levels of Scr and BUN comapred with the control group(P<0.05).The CCr of the two groups decreased,but the observation group had a higher CCr than the control group at 24 and 48 hours after surgery(P<0.05).There was no statistically significant difference in the incidence of adverse events between the observation group(2.33%,1/43)and the control group(6.88%,3/43),P>0.05.Conclusions LC combined with hydration can reduce the incidence of CIN,protect renal function,and effectively prevent CIN after interventional surgery in CHD patients with renal insufficiency.