活血泄浊方对老年冠心病PCI术后急性肾损伤的防治作用

Promoting Blood Circulation and Removing Turbidity Prescription in the Prevention and Treatment of Acute Kidney Injury in Elderly Patients with Coronary Heart Disease after PCI

目的观察活血泄浊方防治老年冠心病患者经皮冠状动脉介入术(PCI)术后对比剂急性肾损伤(CI-AKI)的临床效果。方法选取90例老年冠心病患者随机分为3组,每组30例,其中3组患者均在PCI术前6 h至术后12 h,以一定的速度静脉滴注0.9%氯化钠进行水化,A、C组滴速为1 ml/(kg·h),B组滴速为1.5 ml/(kg·h),同时C组患者在PCI术前2 d至术后5 d口服活血泄浊方,每日1剂。观察3组患者CI-AKI的发生率及术前、术后肾功能指标、炎症指标的水平。结果术后C组CI-AKI发生率最低,优于A组(P<0.05);术后5 d,3组患者SUA、CysC、IL-6均较术后24 h降低,其中C组SUA、CysC、IL-6水平低于A组、B组(P<0.05)。结论PCI术围手术期应用活血泄浊方具有肾脏保护作用,可防治对比剂肾病。

Objective To observe the clinical effect of promoting blood circulation and removing turbidity prescription on acute kidney injury(CI-AKI)in elderly patients after PCI.Methods A total of 90 patients were randomly divided into 3 groups,with 30 patients in each group.All patients in the three groups were given 0.9%sodium chloride intravenous drip for hydration at a certain rate from 6 hours before PCI to 12 hours after surgery,with the drip rate of 1 ml/(kg·h)in group A and group C,and 1.5 ml/(kg·h)in group B.Meanwhile,patients in group C were given an oral dose of promoting blood circulation and removing turbidity prescription,one dose per day from 2 days before PCI to 5 days after surgery.The incidence of CI-AKI and the levels of renal function and inflammation before and after operation were observed.Results The incidence of CI-AKI in group C was the lowest and better than that in group A(P<0.05).The level of SUA,CysC,IL-6 in group C was lower than that in group A and group B(P<0.05).Conclusion The application of promoting blood circulation and removing turbidity prescription in perioperative period of PCI has renal protection effect and can prevent and treat contrast nephropathy.