普罗布考对经皮冠状动脉介入治疗术后造影剂肾病的预防作用  

The preventive effects of Probucol on contrast induced nephropathy in patients undergoing percutaneous coronary intervention

作　　者：张鹏[1] 杨世诚[1] 付乃宽[1] 

机构地区：[1]天津市胸科医院心内科,天津300222

出　　处：《临床心血管病杂志》2015年第11期1163-1166,共4页Journal of Clinical Cardiology

基　　金：天津市卫生局攻关项目(No:10KG122)

摘　　要：目的：探讨普罗布考对经皮冠状动脉介入治疗（PCI）术后造影剂肾病（CIN）的预防作用及其可能机制。方法：入选行PCI术患者共250例,随机将其分为普罗布考组125例和对照组125例。2组均给予足量水化,普罗布考组每日给予普罗布考500mg每天2次口服,对照组仅给予常规治疗。观察2组患者PCI术前及术后48~72h血尿素氮（BUN）、肌酐（Scr）、肾小球滤过率（eGFR）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）、丙二醛（MDA）的变化,记录2组患者CIN发生情况。CIN定义为Scr水平较原有基础升高〉25%或者绝对值升高〉44.2μmol/L以上。结果：2组PCI术前血BUN、Scr、eGFR、CRP、IL-6、MDA差异无统计学意义（P〉0.05）。2组术后72h血Scr、CRP、IL-6、MDA均较术前增高;术后72h,普罗布考组CRP、IL-6、MDA水平低于常规组,eGFR高于对照组（P〈0.05或P〈0.01）。普罗布考组有3例发生CIN,CIN发生率为2.4%;对照组有12例发生CIN,发生率为9.6%,差异有统计学意义（χ2=5.75,P〈0.05）。多元Logistic回归分析结果显示普罗布考是CIN独立保护因素（OR=0.079,95%CI：0.009~0.725,P=0.025）。结论：普罗布考对降低PCI术后CIN的发生具有保护作用,可能与普罗布考抗氧化应激及抗炎症反应有关。Objective：To investigate the preventive effects of probucol on contrast induced nephropathy（CIN）in patients undergoing percutaneous coronary intervention（PCI）.Methods：Two hundred and fifty patients who are about to undergo PCI in Tianjin Chest Hospital are randomly divided into either probucol group（n=120）or control group（n=122）.Patients in the probucol group are given probucol 500 mg Bid three days before PCI.The levels of blood urea nitrogen（BUN）,serum creatinine（Scr）,estimated glomerular filtration rate（eGFR）,interleukin-6（IL-6）,C-reactive protein（CRP）,Malondialdehyde（MDA）were measured at admission and 72 hafter the procedure.Result：（1）In the probucol group,only 3patients present with CIN,the incidence of CIN was 2.4%;In the control group,CIN occur in twelve patients,the incidence of CIN was 9.6%（χ2=5.75,P〈0.05）.Logistic regression analysis showed that probucol is protection factors for CIN（OR=0.079,95%CI 0.009~0.725,P=0.025）.（2）There was no statistically difference in the levels of BUN,Scr,eGFR,CRP,IL-6,MDA at admission（P〈0.05）.72 hafter the procedure,the levels of CRP,IL-6,MDA were lower in probucol than the control group（P〈0.05）,and the levels of eGFR were higher in the probucol group（P〈0.05 or P〈0.01）.Conclusion：Probucol before PCI may be beneficial in the prevention of CIN.The protection mechanism may be due to the anti-inflammation and antioxidant sress effects.

关 键 词：普罗布考 造影剂 冠心病 经皮冠状动脉血管成形术 预防 

分 类 号：R541.4[医药卫生—心血管疾病]