复方丹参滴丸对经皮冠状动脉介入治疗术后对比剂肾病及患者预后的影响
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篇名: 复方丹参滴丸对经皮冠状动脉介入治疗术后对比剂肾病及患者预后的影响
TITLE: Effects of Compound Danshen Dripping Pills on Contrast-induced Nephropathy after Percutaneous Coronary Intervention and Patients ’Prognosis
摘要: 目的:观察复方丹参滴丸预防经皮冠脉介入治疗(PCI)后对比剂肾病(CIN)的效果及其对患者临床预后的影响。方法:将2020年1-6月于天津市胸科医院接受PCI治疗的240例冠心病患者按随机数字表分为对照组(120例)和丹参滴丸组(120例)。两组患者均经桡动脉鞘管或者股动脉鞘管缓慢注射碘帕醇注射液1~5mL,并于PCI治疗前后进行静脉水化治疗;丹参滴丸组患者在此基础上,于PCI治疗前3d及PCI治疗后长期口服复方丹参滴丸,每次270mg,每天3次。观察两组患者PCI治疗前及治疗后72h的血清肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、胱抑素C(Cys-C)、肌酐清除率(Ccr)]、炎症反应指标[超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)]以及氧化应激指标[丙二醛(MDA)]水平;记录PCI治疗后3d患者CIN的发生情况以及随访1年期间主要心血管不良事件的发生情况。结果:PCI治疗前,两组患者血清肾功能指标、炎症反应指标和氧化应激指标水平比较,差异均无统计学意义(P>0.05);PCI治疗后72h,两组患者血清Scr、BUN、Cys-C、hs-CRP、IL-6、MDA水平均较治疗前显著升高,Ccr均较治疗前降低,且丹参滴丸组各指标均显著优于对照组(P<0.05)。丹参滴丸组患者治疗后CIN的发生率为4.2%,随访期间主要心血管不良事件总发生率为13.3%,分别显著低于对照组的13.3%和27.5%(P<0.05)。结论:复方丹参滴丸对预防冠心病患者PCI治疗后CIN的发生可能具有一定效果,并可降低患者主要心血管不良事件的发生率。
ABSTRACT: OBJECTIVE:To observe the effects of Compound danshen drip ping pills on the prevention of contrast-induced nephropathy(CIN)after percutaneous coronary intervention (PCI)and its influence on clinical prognosis. METHODS :From Jan. to Jun. 2020,240 patients with coronary heart disease receiving PCI in Tianjin Chest Hospital were randomly divided into control group(120 cases)and Danshen dripping pills group (120 cases)according to random number table. The patients in both groups were injected with Lippaclitanol injection 1-5 mL slowly through radial or femoral artery sheath ,and intravenous hydration was performed before and after PCI ;Danshen dripping pills group was additionally given Compound danshen dripping pills 270 mg orally for a long term ,three times a day ,three days before and after PCI ,on the basis of the control group. The levels of renal function indexes [serum creatinine (Scr),blood urea nitrogen (BUN),cystatin C (Cys-C),creatinine clearance rate (Ccr)], inflammatory reaction indexes [high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6)] and oxidative stress index [malondialdehyde (MDA)] were observed in 2 groups before and 72 hours after PCI. The occurrence of CIN in 2 groups was recorded 3 days after PCI therapy ;the occurrence of major cardiovascular adverse events was also observed during 1-year follow-up period. RESULTS :Before treatment ,there was no significant difference in serum renal function indexes ,inflammatory reaction indexes and oxidative stress index between 2 groups(P>0.05). Seventy-two hours after PCI ,serum levels of Scr ,BUN, Cys-C,hs-CRP,IL-6 and MDA were increased significantly in 2 groups than before treatment ,while the Ccr were decreased significantly;those indexes of Danshen dripping pills group were significantly better than those of control group (P< 0.05). The incidence of CIN in Danshen dripping pills group was 4.2% after treatment , and total incidence of major cardiovascular adverse events was 13.3% during follow-up period,which were sign ificantly lower than 13.3% and 27.5% of control group (P<0.05). CONCLUSIONS :Compound danshen dripping pills may have a certain effect on the prevention of CIN in coronary heart disease patients after PCI ,and can reduce the incidence of major cardiovascular adverse events.
期刊: 2021年第32卷第15期
作者: 张亚梅,马玉凤,杨世诚,刘园园
AUTHORS: ZHANG Yamei ,MA Yufeng ,YANG Shicheng ,LIU Yuanyuan
关键字: 复方丹参滴丸;经皮冠状动脉介入治疗;对比剂肾病;冠心病;预后
KEYWORDS: Compound danshen dripping pills ;Percutaneous coronary intervention ;Contrast-induced nephropathy ;Coronary
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