黄葵胶囊在预防钆造影剂诱导的肾源性系统纤维化中的作用
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篇名: 黄葵胶囊在预防钆造影剂诱导的肾源性系统纤维化中的作用
TITLE:
摘要: 目的:探讨黄葵胶囊在预防含钆造影剂诱导的肾源性系统纤维化中的应用价值。方法:选择2015年1月-2016年3月我院接受磁共振血管成像(MRA)检查的患者100例,根据检查后是否应用黄葵胶囊将其分为对照组(52例)和观察组(48例)。两组患者均于检查前使用钆喷酸葡胺注射液或钆贝普胺注射液0.2~0.6 mg/kg。对照组患者检查后并未采取任何防治措施;观察组则于检查结束当日开始服用黄葵胶囊2.5 g,tid,连续服用14 d,比较检查前、检查后14 d两组患者肾功能指标、血脂水平、纤维化指标、血清和尿液结缔组织生长因子(CTGF)水平、血清和尿液血管紧张素(Ang)Ⅱ水平、炎性因子水平、肾源性系统纤维化和不良反应的发生情况。结果:检查前,两组患者肾功能指标、血脂水平、纤维化指标、CTGF和AngⅡ水平、炎性因子水平比较,差异均无统计学意义(P>0.05)。检查后14 d,观察组患者肾功能指标、血脂水平、纤维化指标、CTGF和AngⅡ水平、炎性因子水平与检查前比较,差异均无统计学意义(P>0.05);对照组患者血清尿素氮(BUN)、肌酐(Scr)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、透明质酸(HA)、血清和尿液CTGF、血清和尿液AngⅡ水平均显著升高,内生肌酐清除率(Ccr)显著降低,且上述指标及肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6水平的变化均较观察组更为显著,差异均有统计学意义(P<0.05),而血脂水平、hs-CRP与检查前比较,差异均无统计学意义(P>0.05)。观察组患者肾源性系统纤维化的发生率(1.92%)明显低于对照组(18.75%),差异有统计学意义(P<0.05);两组患者在服用黄葵胶囊期间无任何不良反应发生。结论:黄葵胶囊能一定程度预防钆造影剂诱导的肾源性系统纤维化及MRA检查后患者的肾功能异常,且安全性良好。
ABSTRACT: OBJECTIVE: To investigate the value of Huangkui capsules in preventing gadolinium contrast medium-induced nephrogenic systemic fibrosis. METHODS: 100 patients receiving MRA in our hospital from Jan. 2015 to Mar. 2016 were selected and divided into control group (52 cases) and observation group (48 cases) according to whether patients received Huangkui capsules or not after examination. Both groups received Gd-DTPA injection or Gadobenate dimeglumnine injection 0.2-0.6 mg/kg; control group didn’t accept any treatment after MRA; on the day of MRA, observation group was given Huangkui capsule, 2.5 g, tid, for 14 d. The renal function indexes, blood lipid levels, fibrosis indexes, the levels of CTGF and AngⅡ in serum and urine, inflammatory factor levels, the occurrence of nephrogenic systemic fibrosis and ADR were compared between 2 groups before examination and 14 d after examination. RESULTS: Before examination, there was no statistical significance in renal function indexes, blood lipid levels, fibrosis indexes, the levels of CTGF and AngⅡ, inflammatory factor levels between 2 groups (P>0.05). There was statistical significance in renal function indexes, blood lipid levels, fibrosis indexes, the levels of CTGF and AngⅡ, inflammatory factor levels of observation group between 14 d after examination and before examination, without statistical significance (P>0.05). The levels of BUN, Scr, LN, PC-Ⅲ and HA, serum and urine levels of CTGF and AngⅡ were significantly increased in control group, while Ccr level was decreased significantly; the changes of above indexes, TNF-α and IL-6 were more significant than observation group, with statistical significance (P<0.05). There was no statistical significance in blood lipid and hs-CRP before and after examination (P>0.05). The incidence of nephrogenic systemic fibrosis in observation group (1.92%) was significantly lower than in control group (18.75%), with statistical significance (P<0.05). No ADR was found in 2 groups during treatment. CONCLUSIONS: Huangkui capsule can prevent gadolinium contrast medium-induced nephrogenic systemic fibrosis and renal function disorder after MRA to certain extent with good safety.
期刊: 2016年第27卷第32期
作者: 张艳,王琳
AUTHORS: ZHANG Yan,WANG Lin
关键字: 黄葵胶囊;钆造影剂;磁共振血管造影检查;肾源性系统纤维化;应用价值
KEYWORDS: Huangkui capsules; Gadolinium contrast medium; MRA; Nephrogenic systemic fibrosis; Application value
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