普罗布考预防经皮冠状动脉介入治疗术后造影剂肾病的效果分析  

Clinical effect of probucol in prevention of contrast induced nephropathy after percutaneous coronary intervention

作　　者：赵倡武[1] 张颖[1] 陈建涛[1] 

机构地区：[1]焦作市第二人民医院 河南理工大学第一附属医院心内科二区,河南省焦作454001

出　　处：《中国基层医药》2017年第10期1478-1482,共5页Chinese Journal of Primary Medicine and Pharmacy

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.方法 选取96例冠心病且均需行PCI术患者为研究对象,按随机数字表法将其分为对照组48例和观察组48例.对照组患者予常规治疗,观察组患者在常规治疗基础上加用普罗布考治疗.比较两组患者PCI术前和术后24 h、48 h、72 h时血清肌酐（Scr）、胱抑素C（CysC）、尿素氮（Bun）、肾小球滤过率（eGFR））以及C-反应蛋白（CRP）、白细胞介素6（IL-6）和丙二醛（MAD）水平,观察两组患者在治疗过程中的不良反应.结果两组术前Scr、CysC、Bun、eGFR差异均无统计学意义（t=0.149,P=0.882;t=1.75,P=0.243;t=0.133,P=0.894;t=0.019,P=0.985）;两组术后Scr、CysC、Bun、eGFR差异均有统计学意义（t=3.242,P=0.002;t=9.532,P〈0.001;t=9.073,P〈0.001;t=2.896,P〈0.001）,且Scr、CysC、Bun、eGFR水平均在术后24 h逐渐升高,至48 h达顶峰,72 h呈下降趋势,观察组升高及下降幅度均明显大于对照组.两组术前CRP、IL-6和MAD差异均无统计学意义（t=0.321,P=0.749;t=0.014,P=0.989;t=0.188,P=0.850）,术后两组CRP、IL-6和MAD水平差异均有统计学意义（t=8.495,P=0.002;t=7.532,P〈0.00;t=16.216,P〈0.001）,且其CRP、IL-6和MAD水平均在术后24 h逐渐上升,48 h达最高值,72 h呈下降趋势,且上升及下降趋势观察组均明显大于对照组.两组患者治疗过程中均无明显不良反应发生.结论 普罗布考除对冠心病患者有调脂和抗动脉粥样硬化作用外,对行PCI术后的CIN有着一定预防效果,可作为临床上预防治疗CIN的优选药物之一.Objective To analyze the clinical effect of probucol in prevention of contrast induced nephropathy（CIN） after percutaneous coronary intervention（PCI）.Methods 96 patients with coronary heart disease requiring PCI surgery in our hospital were selected as the research subjects, and they were randomly divided into control group（48 cases） and observation group（48 cases）.Both two groups were given traditional treatment, besides this, the observation group was given additional probucol （3 d treatment before and after operation,0.5 g/time,2 times/d）.The renal function indicators such as serum creatinine （Scr）, cystatin C（CysC）, blood urea nitrogen（Bun）, estimated glomerular filtration rate（eGFR）, and the expression levels of C-reactive protein（CRP）,interleukin-6（IL-6） and malondialdehyde（MAD） in the two groups 24 h,48 h, 72 h before and after PCI were observed and compared.And the adverse reactions during operation in the two groups were also recorded and compared.Results There were no significant differences in Scr,CysC,Bun and eGFR between the two groups before opertion（t=0.149,P=0.882;t=1.75,P=0.243;t=0.019,P=0.985）.12 h after operation, the Scr,CysC,Bun and eGFR levels in the two groups were gradually increased,48 h post-treatment, the levels reached to the peak and showed a downward trend 72 h after operation;compared with the control group, the rise and decline in the observation group were more greater, and the differences were statistically significant （t=3.242,P=0.002;t=9.532,P〈0.001;t=9.073,P〈0.001;t=2.896,P〈0.001）.There were no significant differences in CRP,IL-6 and MAD between the two groups before operation （t=0.321,P=0.749;t=0.014,P=0.989;t=0.188,P=0.850）.24 h after operation, the CRP,IL-6 and MAD levels in the two groups were gradually increased,48 h post treatment, the levels reached to the peak and showed a downward trend 72 h after operation;compared with the control group, the rise and decline in the observation group were more greater,

关 键 词：肾病 血管成形术 冠状动脉 普罗布考 

分 类 号：R541.4[医药卫生—心血管疾病] R692[医药卫生—内科学]