| 肾毒宁方联合水化治疗对择期经皮冠状动脉介入术后对比剂肾病的预防作用 |
| Preventive Effect of Shenduning Prescription Combined with Hydration Therapy on Contrast Induced Nephronpathy after Elective Percutaneous Coronary Intervention |
| DOI： |
| 中文关键词: 经皮冠状动脉介入诊疗、水化治疗、肾毒宁方、对比剂肾病、评估肾小球滤过率 |
| 英文关键词: percutaneous coronary intervention, hydration therapy, Shenduning prescription, contrast induced nephronpathy, estimated glomerular filtration rate |
| 基金项目::浙江省中医药科技计划项目(项目编号:2021ZB317)；浙江省医药卫生科技项目(项目编号:2022KY1337)；浙江中医药大学附属医院科研专项(编号:2022A090) |
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| 中文摘要: |
| 【】 目的:探讨肾毒宁方联合水化治疗对择期经皮冠状动脉介入诊疗术后对比剂肾病(CIN)的预防作用。方法:将135例行择期冠状动脉介入诊疗患者随机分为单纯水化组、强化他汀组和肾毒宁方组,每组各45例。单纯水化组在常规冠心病药物治疗的基础上进行术前术后常规水化治疗。强化他汀组在单纯水化组的基础上加用阿托伐他汀钙片强化治疗,肾毒宁方组在单纯水化组的基础上加用肾毒宁方治疗。分别于入院后次日空腹、术后24h和术后72h采血检测血清肌酐(Scr)、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、丙二醛(MDA)和超氧化物歧化酶(SOD),并根据Scr计算肾小球滤过滤(eGFR)。比较三组各指标和CIN发生率的差异。结果:在术后24h、72h强化他汀组和肾毒宁方组的Scr和NGAL水平显著低于单纯水化组,eGFR水平显著高于单纯水化组,差异均有统计学意义(P<0.05)。术后单纯水化组CIN发生率为17.8%,强化他汀组为8.9%,肾毒宁方组为4.4% (χ2 = 4.463, P=0.107)。术后72h,肾毒宁方组MDA水平显著低于单纯水化组和强化他汀组,SOD水平显著高于单纯水化组和强化他汀组,差异均有统计学意义(P<0.05)。强化他汀组肝功能异常比例为17.8%,肾毒宁方组肝功能异常比例为4.4%,差异有统计学意义(χ2 = 4.050, P=0.045)。结论:肾毒宁方联合水化治疗可保护择期冠状动脉介入诊疗术后患者的肾功能,同时降低CIN的发生率和对比剂引起的氧化应激反应,有效减少不良反应。 |
| 英文摘要: |
| Objective?— To explore the preventive effect of Shenduning prescription combined with hydration therapy on contrast induced nephronpathy (CIN) after elective percutaneous coronary intervention.?Methods?— 135 patients undergoing selective coronary intervention were divided into simple hydration group, intensive statin group and Shenduning prescription group randomly, with 45 cases in each group. The simple hydration group received conventional drugs for coronary heart disease and preoperative routine hydration therapy. The intensive statin group received intensive treatment with atorvastatin calcium tablets on the basis of the simple hydration group, and the Shenduning prescription group received Shenduning prescription treatment on the basis of the hydration group. Serum creatinine (Scr), neutrophil gelatinase-associated lipocalin (NGAL), malondialdehyde (MDA), superoxide dismutase (SOD) and estimated glomerular filtration rate (eGFR) were detected by blood samples at 24h before and after operation, as well as 72h after operation respectively. The primary endpoint event was the occurrence of CIN. Results?— The Scr and NGAL level of the intensive statin group and the Shenduning prescription?group was significantly lower than that of the simple hydration group, while the eGFR level was significantly higher than that of the simple hydration group, which is of statistical significance (P<0.05), in the 24h and 72h after operation. The incidence of CIN was 17.8% in simple hydration group, 8.9% in intensive statin group and 4.4% in Shenduning prescription?group respectively after operation, of which there was not significant statistical difference among three?groups (χ2 = 4.463, P=0.107). After 72h of the operation, MDA level in Shenduning prescription?group was significantly lower than that in simple hydration group and intensive statin group, while its SOD level was significantly higher than that in simple hydration group and intensive statin group, which is of statistical significance (P<0.05). The proportion of abnormal liver function in intensive statin group and the Shenduning prescription?group was 17.8% and 4.4% respectively, and the difference was statistically significant (χ2 = 4.050, P=0.045). Conclusion?— The combination treatment of Shenduning prescription with hydration therapy may protect the patient’s renal function after elective coronary interventional therapy, while reducing the incidence of CIN and the oxidative stress reaction caused by contrast agent, thus effectively reducing adverse reactions. |
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