保肾片对造影剂肾病的防治作用研究

发布时间：2018-06-13 01:38

本文选题：造影剂肾病 + 冠脉动脉造影术　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:探讨保肾片对冠状动脉造影术(coronary angiography,CAG)和(或)经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)后造影剂肾病(contrast-induced nephropathy,CIN)的预防和治疗作用。方法:将拟行CAG或(和)PCI术的患者80例随机分为两组,①治疗组:常规标准治疗的基础上加保肾片(40例);②对照组:常规标准治疗(40例)。所有患者检测术前24小时、术后24小时及72小时血肌酐(serum creatinine,Scr)、血胱抑素C(serum cystatin C,Cys-C)、尿 β-半乳糖苷酶(β-galactosidase,GAL)。结果:①术后24小时治疗组血Cys-C较对照组降低,有统计学意义(P0.05);术后72小时治疗组Scr、血Cys-C、尿GAL较对照组明显降低,有统计学意义(P0.01),肾小球滤过率(estimated Glomerular Filtration,eGFR)治疗组较对照组高,有统计学意义(P0.01)。②治疗组术后72小时尿GAL较术前降低,有统计学意义(P0.05),Scr较术前明显降低,eGFR较术前升高,有统计学意义(P0.01);术后24小时较术前无明显差异(P0.05);③对照组血Cys-C术后24小时升高,有统计学意义(P0.05);术后72小时Scr、尿GAL、血Cys-C较术前明显升高,eGFR较术前明显降低,差异有统计学意义(P0.01)。④术后72小时共发生CIN 5例,全部为对照组,治疗组发生率为0%;对照组发生率为12.5%,差异有统计学意义(P0.01)。结论:造影剂对肾功能有损害作用;保肾片能够降低Scr、血Cys-C、尿GAL,可能对降低造影剂对肾功能的损害,改善肾功能有一定的作用;保肾片对CIN可能有一定的预防作用。
[Abstract]:Objective: to investigate the preventive and therapeutic effects of Baoshen tablet on contrast-induced nephropathy after coronary angiography (CAG) and / or percutaneous coronary intervention (PCI). Methods: 80 patients undergoing CAG or / or PCI were randomly divided into two groups: the control group (n = 40) and the control group (n = 40). Serum creatinine scr, cystatin serum cystatin Cys-Cn and urinary 尾 -galactosidase (尾 -galactosidase) were detected in all patients 24 hours before operation, 24 hours and 72 hours after operation. Results the blood Cys-C of the treatment group was significantly lower than that of the control group at 24 hours after operation (P 0.05), and that of the treatment group at 72 hours after operation was significantly lower than that of the control group (P 0.01), and the glomerular filtration rate was significantly higher in the treatment group than in the control group. In the treatment group, the urinary gal was significantly decreased at 72 hours after operation, and the level of creatinine (SCR) in the treatment group was significantly lower than that in the preoperative group, and the level of creatinine globulin (GFR) was significantly increased in the treatment group. There was no significant difference in serum Cys-C between 24 hours after operation and 24 hours after operation, which was statistically significant (P0.05), and at 72 hours after operation, the levels of serum Cys-C and Cys-C in the control group were significantly higher than those before operation, and the levels of Cys-C in the control group were significantly lower than those in the preoperative group at 72 hours after the operation, and the levels of Cys-C in the control group were significantly lower than those before the operation. There were significant differences in the incidence of cin in the control group (n = 5) and the control group (n = 12. 05) at 72 hours postoperatively. Conclusion: contrast agent can damage renal function, Baoshen tablet can reduce Scrs, blood Cys-Cand urinary Gall, it may have certain effect on reducing renal function damage and improving renal function of contrast agent, and Baoshen tablet may have certain preventive effect on cin.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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