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目的探讨前列地尔对冠心病合并糖尿病患者经皮冠状动脉介入(PCI)术后对比剂肾病(CIN)的预防作用。方法选取长沙医学院附属永州市第三人民医院2015年3月—2016年10月收治的行PCI术治疗的冠心病合并糖尿病患者72例,随机分为对照组和观察组,各36例。对照组患者给予常规治疗,观察组患者在对照组基础上给予前列地尔治疗。比较两组患者治疗前后血肌酐(Scr)、尿素氮(BUN)、血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、肾小球滤过率(GFR),并记录比较两组患者CIN发生情况。结果治疗前,两组患者Scr、BUN、Cys-C、β2-MG及GFR比较,差异无统计学意义(P>0.05);治疗后,观察组患者Scr、BUN、Cys-C、β2-MG低于对照组,GFR高于对照组(P<0.05)。观察组患者CIN发生率低于对照组(P<0.05)。结论前列地尔在冠心病合并糖尿病患者PCI术中的应用效果确切,可有效改善患者的肾功能,降低CIN发生。
Objective To investigate the preventive effect of alprostadil on diabetic nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease complicated with diabetes mellitus. Methods Seventy-two patients with coronary heart disease and diabetes mellitus underwent PCI from March 2015 to October 2016 in Yongzhou Third People’s Hospital Affiliated to Changsha Medical College were randomly divided into control group and observation group, with 36 cases in each group. Patients in the control group were given routine treatment, and patients in the observation group were treated with alprostadil on the basis of the control group. Serum creatinine (Scr), blood urea nitrogen (BUN), serum cystatin C (Cys-C), β2 microglobulin (β2-MG) and glomerular filtration rate (GFR) were compared between the two groups before and after treatment Records were compared between two groups of patients with CIN. Results Before treatment, there were no significant differences in Scr, BUN, Cys-C, β2-MG and GFR between the two groups (P> 0.05). After treatment, Scr, BUN, Cys- Lower than the control group, GFR higher than the control group (P <0.05). The incidence of CIN in observation group was lower than that in control group (P <0.05). Conclusion The application of alprostadil in PCI patients with coronary heart disease complicated with diabetes mellitus is effective, which can effectively improve the renal function and reduce the occurrence of CIN.