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目的分析左卡尼汀对老年冠心病患者经皮冠状动脉介入治疗(PCI)后肾损伤的预防作用。方法选取2014年6月—2016年6月武警山东总队医院收治的老年冠心病患者123例,均行PCI,采用随机数字表法分为对照组62例和观察组61例。两组患者均给予常规药物治疗,对照组患者于PCI前后给予0.9%氯化钠溶液,观察组患者则于PCI前后给予左卡尼汀治疗。比较两组患者对比剂用量,PCI前及PCI后48 h、7 d肾功能指标〔包括血尿酸(SUA)、血肌酐(Scr)、血尿素氮(BUN)、肾小球滤过率(e GFR)、肾素、血管紧张素Ⅱ及醛固酮〕,记录两组患者对比剂肾病(CIN)发生情况。结果两组患者对比剂用量比较,差异无统计学意义(P>0.05)。两组患者PCI前SUA、Scr、BUN、eGFR、肾素、血管紧张素Ⅱ、醛固酮比较,差异无统计学意义(P>0.05);观察组患者PCI后48 h SUA、Scr、BUN、醛固酮低于对照组,eGFR、肾素、血管紧张素Ⅱ高于对照组(P<0.05);两组患者PCI后7 d SUA、Scr、BUN、eGFR、肾素、血管紧张素Ⅱ、醛固酮比较,差异无统计学意义(P>0.05)。观察组患者CIN发生率低于对照组(P<0.05)。结论左卡尼汀可有效减少老年冠心病患者PCI后CIN的发生,有利于减轻肾损伤。
Objective To analyze the preventive effect of levocarnitine on renal injury after percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease. Methods A total of 123 elderly patients with coronary heart disease were enrolled in the Shandong Armed Police Corps Hospital from June 2014 to June 2016. All patients underwent PCI. The patients were divided into control group (n = 62) and observation group (n = 61) by random number table. The patients in both groups were given conventional drug treatment. The patients in control group were given 0.9% sodium chloride solution before and after PCI. The patients in observation group were given levocarnitine before and after PCI. Comparisons were made between the two groups. The renal function indexes (including SUA, Scr, BUN and glomerular filtration rate (eGFR) before PCI and 48 h and 7 d after PCI were compared between the two groups. GFR), renin, angiotensin II and aldosterone. The occurrence of contrast-induced nephropathy (CIN) was recorded in both groups. Results There was no significant difference in contrast medium dosage between the two groups (P> 0.05). There was no significant difference in SUA, Scr, BUN, eGFR, renin, angiotensin Ⅱ and aldosterone between the two groups before PCI (P> 0.05). The levels of SUA, Scr, BUN, The levels of eGFR, renin and angiotensin Ⅱ in the control group were higher than those in the control group (P <0.05). The difference of SUA, Scr, BUN, eGFR, renin, angiotensin Ⅱ and aldosterone between the two groups on the 7th day after PCI was significant No statistical significance (P> 0.05). The incidence of CIN in observation group was lower than that in control group (P <0.05). Conclusion L-carnitine can effectively reduce the occurrence of CIN after PCI in elderly patients with coronary artery disease, which is beneficial to reduce renal injury.