丹红注射液对PCI术后造影剂肾损害的预防作用

作者	单位
张义勤	江苏省徐州市中医院南京中医药大学附属徐州医院心内科
王忠良	江苏省徐州市中医院南京中医药大学附属徐州医院心内科
刘敏	江苏省徐州市中医院南京中医药大学附属徐州医院心内科

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中文摘要:

目的观察丹红注射液对经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗患者造影剂肾损害的预防作用。方法 80例接受PCI的患者随机分为对照组及治疗组,每组40例。两组患者均使用碘普罗胺注射液为造影剂,均常规使用肠溶阿司匹林、倍他乐克等药物治疗及常规水化治疗,治疗组于PCI术前2～3天至术后3天加用丹红注射液20 mL加入0.9%氯化钠注射液250 mL静脉滴注,每天1次。分别测定两组PCI术前及术后24、48、72 h的血清肌酐(serum creatinine,SCr)、胱抑素C(cystatin C,CysC)及尿微量白蛋白(mico-albumin,mAlb)、β2-微球蛋白(β2-microglobulin,β2-MG)。观察两组患者造影剂肾病(ra-diocontrast-induced nephropathy,RCIN)的发生率。结果两组患者血清SCr、CysC均在PCI术后24 h达到峰值(P<0.05,P<0.01);治疗组SCr、CysC分别在术后48、72 h即恢复至术前水平,而对照组仅SCr在术后72 h基本恢复至术前水平。治疗组与对照组患者尿mAlb、β2-MG分别在PCI术后24、48 h达到峰值(P<0.05,P<0.01);术后72 h治疗组基本恢复至术前水平,而对照组仍未恢复(P<0.05)。两组患者共发生RCIN 7例,其中对照组5例(12.5%),治疗组2例(5.0%),两组比较差异无统计学意义(P>0.05)。结论丹红注射液对造影剂肾损害有一定的预防作用,可缩短肾损害恢复时间,值得深入研究。

英文摘要:

Objective To investigate the prevention of Danhong Injection(DHI) on contrast-induced renal impairment after percutaneous coronary intervention(PCI).Methods Eighty patients receiving PCI were randomly assigned to the control group and the treatment group,40 in each.All patients used Iopromide Injection as the contrast media,and received routine medicines such as enteric coated aspirin and Betaloc,as well as routine rehydration therapy.As for patients in the treatment group,20 mL DHI was intravenously dripped by adding in 250 mL 0.9% Sodium Chloride Injection from 2-3 days before PCI to 3 days after PCI,once daily.The levels of serum creatinine(SCr),cystatin C(CysC),urine micro-albumin(mAlb),and β2-microglobulin(β2-MG) were measured before PCI,and 24,48,72 h after PCI.The occurrence of radio contrast-induced nephropathy(RCIN) of the two groups was observed.Results The serum SCr and CysC levels of the two groups reached the peak 24 h after PCI(P<0.05,P<0.01).But they respectively restored to the pre-PCI levels at 48 and 72 h after PCI in the treatment group.In the control group the serum SCr level basically restored to the pre-PCI level at 72 h after PCI.The urinary mAlb and β2-MG levels of the two groups reached the peak at 24 and 48 h after PCI(P<0.05,P<0.01),and basically restored to the pre-PCI level at 72 h after PCI.But they did not restore in the control group(P<0.05).Seven patients suffered from RCIN in the two groups,of them 5(12.5%) in the control group and 2(5.0%) in the treatment group,with no statistical difference(P>0.05).Conclusions DHI could effectively prevent contrast-induced renal impairment and shorten the recovery time of renal impairment.It was worth further studies.

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