沙库巴曲缬沙坦钠片对择期经皮冠状动脉介入治疗的慢性心力衰竭患者造影剂肾病的影响  

Effects of sacubitric valsartan sodium tablets on contrast agent nephropathy in patients with chronic heart failure undergoing elective coronary percutaneous coronary intervention

作　　者：曹金龙[1] 马鸿兰 辛宏[1] 蔡天志[1] 刘佰学 张安吉[1] 马小川 张科林 CAO Jinlong;MA Honglan;XIN Hong;CAI Tianzhi;LIU Baixue;ZHANG Anji;MA Xiaochuan;ZHANG Kelin(Departmet of Cardiology,the First Affiliated Hospital of Xi'an Medical College,Xi'an 710077,Shaanxi Province,China)

机构地区：[1]西安医学院第一附属医院心内科,陕西西安710077

出　　处：《世界临床药物》2021年第6期478-482,共5页World Clinical Drug

摘　　要：目的探讨沙库巴曲缬沙坦钠片对造影剂肾病(contrast induced nephropathy,CIN)的影响和机制。方法选取我院心内科收治的慢性心力衰竭且行择期经皮穿刺冠状动脉介入(percutaneous coronary intervention,PCI)治疗患者108例,分为研究组及对照组,每组54例。入选患者按照目前临床标准化治疗心力衰竭的方案进行干预治疗,研究组口服给予沙库巴曲缬沙坦钠片(一日2次,每次100 mg),对照组口服给予缬沙坦(一日1次,每次80 mg)。入院后两组经规范抗心力衰竭治疗同时均完成冠状动脉造影及PCI,在PCI术前6 h和术后12 h,两组常规给予水化治疗。检测两组术前及术后24、72 h血清肌酐、胱抑素C水平,计算肾小球滤过率估算值(estimate glomerular filtration rate,eGFR)和CIN发生率;观察干预前后尿肾损伤分子水平变化。两组患者术后规律门诊复诊复查,未复诊患者通过电话进行随访联系,观察3个月,记录主要心血管不良事件情况并进行比较。结果研究组术后72 h血肌酐和胱抑素C水平较对照组明显降低;同时,eGFR水平高于对照组(P<0.05)。研究组术后24 h尿肾损伤分子-1较对照组明显降低(P<0.05)。研究组CIN发生率显著低于对照组(P<0.05)。术后两组间主要心血管不良事件无显著差异(P>0.05)。结论沙库巴曲缬沙坦钠片在择期PCI治疗过程中,可降低冠状动脉粥样硬化性心脏病心力衰竭患者CIN发生率。Objective To explore the effects of sacubitric valsartan sodium tablets on contrast induced nephropathy (CIN).Methods A total of 108 patients with chronic heart failure treated by elective percutaneous coronary intervention (PCI) in the department of cardiology in our hospital were selected and divided into study group and control group,with 54 cases in each group.Intervention was carried out in the selected patients according to the current clinical standardized treatment for heart failure.The study group was treated with sacubitric valsartan sodium tablets (100 mg twice a day),and the control group was treated with valsartan (80 mg once a day).After admission,both groups completed coronary angiography and PCI after standard anti-heart failure treatment,and the two groups were routinely given hydration treatment 6 hours before and 12 hours after PCI.Serum creatinine,cystatin C and the incidence of estimated glomerular filtration rate(eGFR) and CIN were measured in the 2 groups at 24 and 72 hours before and after PCI.The changes of urine damage molecule were observed,and the changes of kidney injury molecular level after drug intervention in the two groups were obserued.The patients in the two groups received regular outpatient follow-up and reexamination after operation.Patients who did not receive follow-up were followed up and contacted by telephone.Major cardiovascular adverse events were observed and recorded for 3 months for comparison.Results The serum creatinine and cystatin C level of the study group were significantly lower than those in the control group at 72 hours after operation.At the same time,the eGFR level was higher than that in the control group (P<0.05).Urinary kidney injury molecule-1 in the study group was significantly lower than that in the control group (P<0.05).The incidence of CIN in the study group was significantly lower than that in the control group (P<0.05).There were no significant differences in major cardiovascular adverse events between the two groups after surgery (P>0.05).Co

关 键 词：沙库巴曲缬沙坦钠片 冠状动脉粥样硬化性心脏病 慢性心力衰竭 造影剂肾病 

分 类 号：R541.61[医药卫生—心血管疾病] R541.4[医药卫生—内科学]