尼可地尔与曲美他嗪联合用药对经皮冠脉介入术后对比剂肾病的预防效果  

Prevention effect of nicodil and tremetadzine on contrast nephropathy after percutaneous coronary intervention

作　　者：朱梦晨 胡占嵩[1] 陈丽娟[1] Zhu Mengchen;Hu Zhansong;Chen Lijuan(Department of Pharmacy,Tianjin Chest Hospital,Tianjin 300222,China)

机构地区：[1]天津市胸科医院,天津300222

出　　处：《首都食品与医药》2023年第8期54-57,共4页Capital Food Medicine

摘　　要：目的探讨尼可地尔与曲美他嗪配伍用药对经皮冠脉介入术后对比剂肾病的预防效果。方法回顾性选取2019年1月-2020年1月于天津市胸科医院行经皮冠脉介入术的患者100例,按照随机数字法将其分为对照组与联合组各50例,两组均接受常规药物及术前水化治疗,对照组在此基础上应用曲美他嗪,联合组在此基础上应用曲美他嗪联合尼可地尔。对比分析两组患者的相关手术情况及术前和术后的肾功能、炎症介质因子、术后不良反应发生率。结果两组患者相关手术情况,如经皮冠脉介入术中冠脉病变支数、冠脉支架置入数、对比剂用量、手术时间比较,差异无统计学意义(P>0.05)。术前两组患者的肾功能相关生化指标:血肌酐、尿素氮、肾小球滤过率无明显差异(P>0.05),术后3d,两组患者的血肌酐、尿素氮均有所升高,肾小球滤过率有所下降,且联合组患者的血肌酐、尿素氮低于对照组,肾小球滤过率高于对照组,差异有统计学意义(P<0.05)。术前两组患者的炎症因子:白细胞(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)无明显差异(P>0.05),术后3d,两组患者的炎症因子均有所升高,且联合组患者的CRP、PCT、WBC低于对照组,差异有统计学意义(P<0.05)。术后联合组对比剂肾病的发生率明显低于对照组,P<0.05,差异有统计学意义;两组再发心梗、急性心衰、脑卒中的发生率无明显差异(P>0.05)。结论尼可地尔与曲美他嗪配伍用药可有效降低经皮冠脉介入术后发生对比剂肾病的发生率,相对改善心室重塑、降低对肾功能的影响、减弱炎症反应,有良好的临床应用价值。Objective To investigate the preventive effect of nicrodil and trimetazidine compatibility on contrast nephropathy after percutaneous coronary intervention.Methods Retrospective selection in our percutaneous coronary intervention from January 2019 to January 2020,100 cases of patients,according to the random number method is divided into control group and combination group of 50 cases,both groups receive conventional drugs and preoperative hydration treatment,control group applied trammetadazidine on this basis,the combination group on this basis applied trammetadzidine and nicoldil.The general data of the two groups and the preoperative and postoperative cardiac function,renal function,inflammatory mediators,and the incidence of postoperative adverse reactions were compared analyzed.Results There was no significant difference in the number of coronary artery lesions,the number of coronary stent implantation,the dosage of contrast agent and the operation time between the two groups(P>0.05).Kidney function of the two groups of preoperative biochemical indicators:blood creatinine,BUN,glomerular filtration rate no obvious difference(P>0.05),postoperative 3d two groups of blood creatinine,urea nitrogen increased,glomerular filtration rate has decreased,and the blood creatinine,urea nitrogen less than control group,glomerular filtration rate is higher than the control group,the difference is statistically significant(P<0.05).There was no significant difference in leukocyte(WBC)(CRP)and C-reactive protein(PCT)(P>0.05),and it was increased in both patients 3d after surgery,and CRP,PCT and WBC were less than in control group,statistically significant(P<0.05).The incidence of contrast nephropathy was significantly lower than the control group,P<0.05;recurrent myocardial infarction,acute heart failure and stroke(P>0.05).Conclusion The association of nicrodil and trimetazidine can effectively reduce the incidence of contrast agent nephropathy after percutaneous coronary intervention,relatively improve ventricular remodeling

关 键 词：尼可地尔 曲美他嗪 经皮冠脉介入术 对比剂肾病 预防 不良反应 

分 类 号：R541.4[医药卫生—心血管疾病]