甲花片对冠状动脉造影或介入治疗后造影剂肾病患者肾损伤指标的影响

武强; 林欣; 缪晓帆; 刘福明

甲花片对冠状动脉造影或介入治疗后造影剂肾病患者肾损伤指标的影响

南京中医药大学附属医院/江苏省中医院，江苏南京 210029

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出版历程
- 刊出日期: 2020-03-10

Effects of Jiahua Tablet on Renal Injury Index of Patients with Nephropathy after Coronary Angiography or PCI

摘要

摘要: 目的观察甲花片对冠状动脉造影或介入治疗后造影剂肾病患者肾小球滤过功能及肾小管损伤指标的影响，评价其防治造影剂肾病的疗效，为造影剂肾病的诊治提供新的中医临床证据。方法选取冠状动脉造影或介入治疗的患者80例，随机分为治疗组、对照组各40例。治疗组在对照组降压类（钙离子拮抗剂、β受体阻滞剂、α受体阻滞剂、利尿剂等）、他汀类、阿司匹林等常规治疗的基础上术前72 h起至术后72 h持续1周服用甲花片每次4片，每日3次，观察患者血肌酐（Scr）、血清尿素氮（BUN）、肾小球滤过率（eGFR）、尿Ｎ-乙酰-β-Ｄ-氨基葡萄糖苷酶（NAG）、尿β-半乳糖苷酶（GAL）等指标的变化。结果 2组术后24 h Scr、BUN水平，NAG、GAL活性与术前相比明显升高，eGFR显著低于术前（P<0.05～0.01），治疗组NAG、GAL活性明显低于对照组（P<0.05～0.01）。治疗组术后72 h Scr、BUN水平，NAG、GAL活性，eGFR与术前相比基本持平（P>0.05），对照组术后72 h Scr、BUN水平，NAG活性明显高于术前水平，eGFR显著低于术前（P<0.01）；治疗组Scr、BUN水平及NAG、GAL活性均明显低于对照组，而eGFR明显高于对照组（P<0.05～0.01）。结论甲花片能改善患者Scr、BUN、NAG、GAL等肾损伤指标的表达，较好地发挥肾脏保护作用，从而达到防治造影剂肾病的目的。
- 甲花片 /
- 冠状动脉造影 /
- 冠心病介入治疗 /
- 造影剂肾病 /
- 肾损伤指标
Abstract: OBJECTIVE To observe the effect of Jiahua tablet on glomerular filtration function and renal tubular injury indexes in patients with contrast-induced nephropathy after coronary angiography or interventional therapy， and to evaluate its efficacy in the prevention and treatment of contrast-induced nephropathy， in order to provide a new clinical evidence for the diagnosis and treatment of contrast-induced nephropathy in traditional Chinese medicine (TCM). METHODS 80 patients with coronary angiography or interventional treatment were selected and randomly divided into treatment group and control group with 40 cases each. Based on such routine treatments of control group as antihypertensive methods (calcium antagonist， β receptor blocker， α receptor blocker， diuretics)， statins and aspirin， the treatment group was treated with 4 Jiahua tablets at a time， 3 times per day from preoperative 72 h till postoperative 72 h in a week. Such changes of index were observed as serum creatinine (Scr)， serum urea nitrogen (BUN)， glomerular filtration rate (eGFR)， urine N-acetyl-β-D-glycosaminidase (NAG) and urine β-galactosidase (GAL). RESULTS After postoperative 24 h， the levels of Scr， BUN， NAG and GAL in the two groups were significantly higher than those of preoperation， and the level of eGFR was markedly lower than that before operation(P<0.05， P<0.01). The activities of NAG and GAL in the treatment group was significantly lower than that of the control group (P<0.05， P<0.01). The postoperative 72 h levels of Scr， BUN， NAG， GAL and eGFR in the treatment group were basically the same as those before the operation (P>0.05).The postoperative 72 h levels of Scr， BUN and NAG in the control group were significantly higher than those of the preoperation， and the level of eGFR was significantly lower than that before the operation (P<0.01). The levels of Scr， BUN， and the activity of NAG and GAL in the treatment group were significantly lower than those of the control group， while the level of eGFR was significantly higher than that of the control group (P<0.05， P<0.01). CONCLUSION Jiahua tablets can improve the expression of renal injury indexes such as Scr， BUN， NAG and GAL， and exert a better renal protective effect， thereby achieving the purpose of preventing and treating contrast-induced nephropathy.
- Jiahua tablet /
- coronary angiography /
- PCI /
- contrast-induced nephropathy /
- renal injury index

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