金水宝胶囊对实施冠脉造影检查的糖尿病患者肾功能的影响  

Effect of Jinshuibao capsule on renal function in diabetic patients undergoing coronary angiography

作　　者：梁改琴[1] 王红霞 王闻奇[1] 张倩[1] 周晟 Liang Gaiqin;Wang Hongxia;Wang Wenqi;Zhang Qian;Zhou Sheng(Department of Radiology,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,Gansu,China;Department of Radiology,Gansu Provincial Hospital,Lanzhou 730050,Gansu,China)

机构地区：[1]甘肃省中医院放射影像科,甘肃兰州730050 [2]甘肃省人民医院放射影像科,甘肃兰州730016

出　　处：《中国中西医结合急救杂志》2023年第1期66-69,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：甘肃省自然科学基金项目(145RJZA100)。

摘　　要：目的观察金水宝胶囊对实施冠脉造影检查前后的糖尿病患者肾功能的影响。方法采用前瞻性研究方法。选择2019年8月至2020年8月在甘肃省中医院行冠脉造影的60例糖尿病患者作为研究对象。将患者按随机数字表法分为金水宝胶囊组和对照组,每组30例。金水宝胶囊组于术前2 d开始口服金水宝胶囊,每日3次,每次3粒,连续服用至术后3 d;对照组术前30 min口服生理盐水350 mL;两组患者术后24 h内饮水量不少于2000 mL,以达到充分水化,加速造影剂排泄。观察术前1 h和术后24、48、72 h两组患者血肌酐(SCr)、血尿素氮(BUN)、肾小球滤过率(GFR)、血清胱抑素C(Cys C)的变化及不良反应和对比剂肾病(CIN)发生率。结果两组术前肾功能指标SCr、BUN、Cys C比较差异均无统计学意义,术后24 h上述指标均较术前1 h明显升高〔SCr(μmol/L):对照组为96.32±21.65比85.36±23.52,金水宝胶囊组为85.39±15.68比82.61±16.47;BUN(mmol/L):对照组为7.98±1.21比4.89±1.23,金水宝胶囊组为5.49±1.23比5.41±1.48;Cys C(mg/L):对照组为3.01±0.29比1.12±0.31,金水宝胶囊组为2.28±0.24比1.17±0.25,均P<0.05〕,术后48 h开始下降,持续到术后72 h时金水宝胶囊组肾功能各项均明显低于对照组〔SCr(μmol/L):82.73±15.36比86.58±30.52,BUN(mmol/L):5.41±1.45比6.34±2.84,Cys C(mg/L):1.18±0.26比2.85±0.32,均P<0.05〕。两组治疗前后各时间点GFR比较差异均无统计学意义。两组患者均有不同程度恶心呕吐、头痛头晕、肢体发冷和寒战等不良反应,但金水宝胶囊组发生率低于对照组(10.0%比20.0%、3.3%比10.0%、3.3%比3.3%),差异均无统计学意义(均P>0.05);但对照组CIN发生率明显高于金水宝胶囊组〔36.7%(11/30)比3.3%(1/30),P<0.05〕。结论金水宝胶囊有保护糖尿病患者肾功能的作用,对降低和预防糖尿病患者实施造影检查发生CIN有一定价值。Objective To observe the effect of Jinshuibao capsule on the renal function of diabetic patients before and after coronary angiography.Methods A prospective study approach was used.Sixty diabetic patients who underwent coronary angiography at Gansu Provincial Hospital of Traditional Chinese Medicine from August 2019 to August 2020 were selected as study subjects.Patients were divided into Jinshuibao capsule group and control group according to the random number table method,with 30 cases in each group.The Jinshuibao capsule group started to take Jinshuibao capsule orally 3 times a day for 3 days before surgery;the control group took 350 mL of saline orally 30 minutes before surgery.Patients in both groups drank at least 2000 mL of water within 24 hours after surgery to achieve adequate hydration and accelerate the excretion of contrast agent.The changes of serum creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(GFR),serum cystatin C(Cys C),and the occurrence of adverse reactions were observed in 1 hour and 24,48 and 72 hours.Results There were no significant differences in the preoperative renal function indicators:SCr,BUN,and Cys C.These indicators were significantly increased at 24 hours after surgery compared with 1 hour before surgery[SCr(μmol/L):the control group was 96.32±21.65 vs.85.36±23.52,the Jinshuibao capsule group was 85.39±15.68 vs.82.61±16.47;BUN(mmol/L):the control group was 7.98±1.21 vs.4.89±1.23,the Jinshuibao capsule group was 5.49±1.23 vs.5.41±1.48;Cys C(mg/L):the control group was 3.01±0.29 vs.1.12±0.31,the Jinshuibao capsule group was 2.28±0.24 vs.1.17±0.25,all P<0.05].The decline started at 48 hours and continued until 72 hours after surgery.And the renal function of Jinshuibao capsule group was significantly lower than that of the control group[SCr(μmol/L):82.73±15.36 vs.86.58±30.52,BUN(mmol/L):5.41±1.45 vs.6.34±2.84,Cys C(mg/L):1.18±0.26 vs.2.85±0.32,all P<0.05].There was no significant difference in GFR comparison at each time point before and after

关 键 词：金水宝胶囊 糖尿病 对比剂肾病 

分 类 号：R587.1[医药卫生—内分泌] R692[医药卫生—内科学]