摘要
目的 探讨前列地尔对高血压患者行经皮冠状动脉介入治疗（PCI）术后对比剂诱导的急性肾损伤（CIAKI）的预防作用。方法 连续入选天津市胸科医院心内科行PCI术的冠状动脉性心脏病合并高血压患者共300例,随机将其分为前列地尔组（150例）和对照组（150例）。对照组给予水化治疗,前列地尔组术前0.5～1.0h及术后3d每日给予前列地尔20μg＋100mL生理盐水静点及水化。观察2组患者PCI术前及术后72h血尿素氮、肌酐、肌酐清除率（Ccr）、β2微球蛋白（β2-MG）、C反应蛋白（CRP）、白细胞介素6（IL-6）水平的变化,记录2组患者的CIAKI发生情况。结果 2组患者PCI术前血尿素氮、肌酐、Ccr、β2-MG、CRP、IL-6差异无统计学意义（P〉0.05）。2组患者术后72h血β2-GM、CRP、IL-6均较术前增高;术后72h,前列地尔组β2-GM[（2.93±0.83）比（3.37±0.70）mg/L]、CRP[（1.52±0.51）比（1.98±0.64）mmol/L]、IL-6[（135.45±31.39）比（144.48±32.41）ng/L]水平低于对照组,Ccr高于对照组[（74.28±10.27）比（71.50±11.35）mL/min],差异有统计学意义（均P〈0.05）。前列地尔组CIAKI发病率低于对照组（2.7%比8.7%,χ2=5.05,P〈0.05）。前列地尔组未见低血压等不良事件发生。结论 前列地尔对降低PCI术后CIAKI的发生可能具有一定益处。
Objective To investigate the preventive effects of alprostadil on contrast-induced acute kidney injury （CIAKI） in patients with hypertension after percutaneous coronary intervention （PCI） operation. Methods A total of 300 patients complicated with coronary heart disease and hypertension were consecutively enrolled from Department of Cardiology, Tianjin Chest Hospital. They underwent PCI and were randomly divided into alprostadil group （n= 150） and control group （ n = 150 ）. Patients in control group received hydration therapy, and those in alprostadil group received 20 tzg alprostadil, 100 mL saline and hydration therapy 0.5-1.0 h before operation and 3 days after operation. The levels of blood urea nitrogen, serum creatinine, creatinine clearance rate （Ccr） , β2-microglobulin （β2-GM）, C-reactive protein （CRP） and interleukin-6 （ IL-6） were detected before and 72 h after PCI operation. The incidence of CIAKI was recorded in both groups. Results There was no statistical difference in the levels of blood urea nitrogen, serum creatinine, Ccr, β2-GM, CRP, and IL-6 before PCI （P〉0.05）. 72 h after PCI, the levels of β2-GM, CRP, IL-6 were increased compared to preoperation. Meanwhile, the concentration of β2-GM, CRP, IL-6 were lower [β2-GM （2.93±0. 83） vs （3.37±0. 70） mg/L, CRP （1.52±0.51） vs （1.98±0. 64） mmol/L, IL-6 （135.45±31.39） vs （144. 48±32.41） ng/L], while Ccr was higher [（74.28±10. 27） vs （71. 505±11.35）mL/min] in the alprostadil group than those in control group （all P〈0.05）. The incidence of CIAKI in atprostadil group was lower than that in control group （2.7 % vs 8.7 %, χ^2 = 5.05, P〈0.05）. No adverse events such as hypotension occurred in alprostadil group. Conclusion Alprostadil may be beneficial in the prevention of CIAKI after PCI.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2016年第8期741-745,共5页
Chinese Journal of Hypertension
基金
天津市卫生和计划生育委员会重点攻关课题(14KG144)
作者简介
通信作者：付乃宽，E-mail：Cdrfnk@163．com
