冠心病造影剂相关肾损害患者的临床保守治疗效果

Analysis of comparison of effects and mechanism of action of two drugs in prevention and treatment of contrast induced renal damage in patients with coronary heart disease

目的 :研究分析两种药物防治冠心病患者造影剂相关肾损害的效果比较及作用机制。方法 :从2015年1月~2016年10月期间收治的冠心病患者中,选取60例患者纳入此研究领域中,均择期行PCI手术,按照入院顺序,单号作为甲组(n=30),双号作为乙组(n=30),甲组给予乙酰半胱氨酸治疗,乙组采用前列地尔治疗。结果 :甲组患者造影剂肾病发病率为3.33%,与乙组患者6.67%比较,差异无统计学意义;造影后72h甲组患者血清肌酐、血尿素氮、尿β2微球蛋白水平低于乙组,NO、NOS、ET-1水平高于乙组。结论 :对接受PCI冠心病患者,乙酰半胱氨酸、前列地尔对造影剂所致肾损害具有一定的防治作用,在保护肾功能、血管内皮功能等方面,乙酰半胱氨酸较前列地尔更具优势。

Objective To study and analyze the comparison of effects and mechanism of action of two drugs in prevention and treatment of contrast induced renal damage in patients with coronary heart disease. Methods 60 cases of patients with coronary heart disease and who accepted treatments in our hospital from January, 2015 to October, 2016 were selected and enrolled in this study, and all patients were underwent PCI operation. And according to the order of admission, Odd Numbers as the A group(n=30), and the Even Numbers as the B group(n=30). In the A group were given the N-acetylcysteine treatment, while in the B group were treated with alprostadil. Result The incidence of contrast induced nephropathy of patients in the A group was 3.33%, compared with B group of 6.67%, and there was no significant difference; After contrast group 72 h serum creatinine, blood urea nitrogen and urine beta 2 microglobulin level lower than that of group B, NO, NOS and ET-1 were higher than that of group B. The serum creatinine, blood urea nitrogen and urine β2 microglobulin level after the angiography of patients in the A group lower than that of B group, and the levels of NO, NOS and ET-1 were higher than those in B group. Conclusion For patients with coronary heart disease(CHD) treated with PCI, the N-acetylcysteine and alprostadil have some preventive and therapeutic effects on renal damage caused by contrast media, which in the protection of renal function, vascular endothelial function, and so on, N-acetylcysteine has more advantages than alprostadil.