中华老年心脑血管病杂志
中華老年心腦血管病雜誌
중화노년심뇌혈관병잡지
CHINESE JOURNAL OF GERIATRIC CARDIOVASCULAR AND CEREBROVASCULAR DISEASES
2014年
6期
580-583
,共4页
前列地尔%冠心病%造影剂%肾病
前列地爾%冠心病%造影劑%腎病
전렬지이%관심병%조영제%신병
alprostadil%coronary disease%contrast media%nephrosis
目的:探讨前列地尔对老年冠心病患者PCI术后造影剂肾病(CIN )的预防作用。方法前瞻性入选天津市胸科医院心内科拟行PCI的老年冠心病患者300例,按照随机数字表法分为前列地尔组150例,常规治疗组150例。其中前列地尔组给予20μg前列地尔+水化治疗,常规治疗组仅给予单纯水化治疗。观察2组患者PCI术前及术后3 d血肌酐、肌酐清除率、尿素、β2微球蛋白、24 h尿蛋白、C反应蛋白(CRP)、白细胞介素6(IL-6)、TNF-α、谷胱甘肽过氧化物酶(GPX)和超氧化物歧化酶(SOD)水平的变化,并分析2组患者CIN发病情况,记录前列地尔组低血压不良事件。结果前列地尔组PCI术后CRP[(1.28±1.28)mg/L vs (1.66±1.72)mg/L]、IL-6[(136.42±43.76)ng/L vs (141.26±65.70)ng/L]、SOD[(2.05±1.48)mg/L vs (2.38±1.41)mg/L]、GPX[(6.46±2.32)μg/L vs (6.94±2.09)μg/L)]、24 h尿蛋白[(189.55±87.56)mg vs (197.51±89.62)mg]、CIN发病率[(2.7% vs 8.7%)]较常规治疗组明显降低,肌酐清除率[(97.75±27.20)ml/min vs (91.70±17.85)ml/min]较常规治疗组明显增高,差异有统计学意义(P<0.05)。2组PCI术后CRP、IL-6、SOD、GPX、24 h尿蛋白较术前明显增高,差异有统计学意义(P<0.05);而2组术后肌酐清除率、血肌酐、尿素、β2微球蛋白、TNF-α水平较术前无明显变化(P>0.05)。结论前列地尔具有保护接受PCI术冠心病患者肾功能的作用,对CIN可能有一定的预防作用。
目的:探討前列地爾對老年冠心病患者PCI術後造影劑腎病(CIN )的預防作用。方法前瞻性入選天津市胸科醫院心內科擬行PCI的老年冠心病患者300例,按照隨機數字錶法分為前列地爾組150例,常規治療組150例。其中前列地爾組給予20μg前列地爾+水化治療,常規治療組僅給予單純水化治療。觀察2組患者PCI術前及術後3 d血肌酐、肌酐清除率、尿素、β2微毬蛋白、24 h尿蛋白、C反應蛋白(CRP)、白細胞介素6(IL-6)、TNF-α、穀胱甘肽過氧化物酶(GPX)和超氧化物歧化酶(SOD)水平的變化,併分析2組患者CIN髮病情況,記錄前列地爾組低血壓不良事件。結果前列地爾組PCI術後CRP[(1.28±1.28)mg/L vs (1.66±1.72)mg/L]、IL-6[(136.42±43.76)ng/L vs (141.26±65.70)ng/L]、SOD[(2.05±1.48)mg/L vs (2.38±1.41)mg/L]、GPX[(6.46±2.32)μg/L vs (6.94±2.09)μg/L)]、24 h尿蛋白[(189.55±87.56)mg vs (197.51±89.62)mg]、CIN髮病率[(2.7% vs 8.7%)]較常規治療組明顯降低,肌酐清除率[(97.75±27.20)ml/min vs (91.70±17.85)ml/min]較常規治療組明顯增高,差異有統計學意義(P<0.05)。2組PCI術後CRP、IL-6、SOD、GPX、24 h尿蛋白較術前明顯增高,差異有統計學意義(P<0.05);而2組術後肌酐清除率、血肌酐、尿素、β2微毬蛋白、TNF-α水平較術前無明顯變化(P>0.05)。結論前列地爾具有保護接受PCI術冠心病患者腎功能的作用,對CIN可能有一定的預防作用。
목적:탐토전렬지이대노년관심병환자PCI술후조영제신병(CIN )적예방작용。방법전첨성입선천진시흉과의원심내과의행PCI적노년관심병환자300례,안조수궤수자표법분위전렬지이조150례,상규치료조150례。기중전렬지이조급여20μg전렬지이+수화치료,상규치료조부급여단순수화치료。관찰2조환자PCI술전급술후3 d혈기항、기항청제솔、뇨소、β2미구단백、24 h뇨단백、C반응단백(CRP)、백세포개소6(IL-6)、TNF-α、곡광감태과양화물매(GPX)화초양화물기화매(SOD)수평적변화,병분석2조환자CIN발병정황,기록전렬지이조저혈압불량사건。결과전렬지이조PCI술후CRP[(1.28±1.28)mg/L vs (1.66±1.72)mg/L]、IL-6[(136.42±43.76)ng/L vs (141.26±65.70)ng/L]、SOD[(2.05±1.48)mg/L vs (2.38±1.41)mg/L]、GPX[(6.46±2.32)μg/L vs (6.94±2.09)μg/L)]、24 h뇨단백[(189.55±87.56)mg vs (197.51±89.62)mg]、CIN발병솔[(2.7% vs 8.7%)]교상규치료조명현강저,기항청제솔[(97.75±27.20)ml/min vs (91.70±17.85)ml/min]교상규치료조명현증고,차이유통계학의의(P<0.05)。2조PCI술후CRP、IL-6、SOD、GPX、24 h뇨단백교술전명현증고,차이유통계학의의(P<0.05);이2조술후기항청제솔、혈기항、뇨소、β2미구단백、TNF-α수평교술전무명현변화(P>0.05)。결론전렬지이구유보호접수PCI술관심병환자신공능적작용,대CIN가능유일정적예방작용。
Objective To study the role of prostaglandin E1 in prevention of contrast-induced ne-phropathy (CIN)in elderly CHD patients undergoing PCI .Methods Three hundred elderly CHD patients who were going to undergo PCI in Tianjin Chest Hospital were divided into prostaglandin E1 treatment group (n=150) and conventional treatment group (n=150) .Patients in prostaglan-din E1 treatment group were treated with 20 μg prostaglandin E1 plus hydration therapy and those in conventional treatment group received simple hydration therapy .T heir serum levels of creatinine ,urea ,β2-microglobulin ,24 h proteinuria ,CRP ,IL-6 ,TNF-α,GPX ,SOD ,and creatinine clearance rate were measured before and 3 d after PCI .The incidence of CIN in two groups was analyzed .The hypotension events in prostaglandin E1 treatment group were recorded .Results The serum levels of CRP ,SOD ,GPX ,24 h proteinuria and the incidence of CIN were significantly lower while the creatinine clearance rate was significantly higher in prostaglandin E 1 treatment group than in conventional treatment group after PCI (P<0 .05) .The serum levels of CRP ,IL-6 , SOD ,GPX and 24 h proteinuria were significantly higher in two groups after PCI than before PCI (P<0 .05) .Conclusion Prostaglandin E1 can protect the renal function in CHD patients under-going PCI and play a certain role in preventing CIN .