摘要
目的:探讨重组人B型钠尿肽(rh BNP)对合并慢性充血性心力衰竭(CHF)患者造影剂肾病(CIN)的防治效果。方法:选择行择期经皮冠状动脉介入治疗(PCI)的合并CHF的不稳定性心绞痛患者168例,分为rh BNP组(82例)和对照组(86例),两组患者均接受常规药物及水化治疗,rh BNP组在此基础上于PCI术前12 h开始应用rh BNP至术后24 h。测定PCI术前、术后24和48 h血肌酐(SCr)、估计的肾小球滤过率(e GFR),统计CIN发生率;测定PCI术前、术后1和7 d血浆B型钠尿肽(BNP)水平、左室射血分数(LVEF)、左室舒张末内径(LVEDD)。结果:rh BNP组患者术后SCr较术前逐渐升高但低于对照组(F组间=9.399,F时间=24.566,F交互=26.008,P<0.01),e GFR较术前逐渐降低但均高于对照组(F组间=12.880,F时间=33.263,F交互=25.307,P<0.01),rh BNP组CIN发生率低于对照组(3.7%vs 16.3%,χ2=7.351,P=0.007)。rhB NP组术后血浆BNP水平较术前降低,对照组则较术前升高(F组间=9.148,F时间=4.745,F交互=216.413,P<0.05)。rhB NP组术后LVEF逐渐升高,LVEDD逐渐缩小;对照组术后1天LVEF较术前明显降低,LVEDD明显增大,术后7 d恢复至术前水平(LVEF:F组间=7.497,F时间=3.740,F交互=118.041,P<0.05;LVEDD:F组间=19.116,F时间=5.782,F交互=106.593,P<0.05)。结论:rhB NP联合水化治疗可改善CHF患者心功能,减少CIN的发生。
Aim：To investigate the prevention effects of recombinant human B-type natriuretic peptide（rhBNP） against contrast induced nephropathy （CIN） in patients with chronic congestive heart failure （CHF）.Methods：A total of 168 unsta-ble angina patients with CHF and percutaneous coronary intervention （PCI）, were divided into treatment group （82 cases） and control group（86 cases）.The two groups were treated with routine drugs and hydration , and the treatment group was continu-ously given rhBNP from 12 h before PCI to 24 h after PCI.Serum creatinine（SCr）, estimated glomerular filtration rate（eG-FR） were measured before PCI and 24 h, 48 h after PCI, and the incidence of CIN were analyzed .Plasma level of BNP , left ventricular ejection fraction （ LVEF） , left ventricular end-diastolic dimension （ LVEDD） were measured before PCI and 1 d, 7 d after PCI .Results：SCr increased gradually after PCI in treatment group , but were still lower than that of the control group （Fgroup =9.399, Ftime =24.566,Finteraction =26.008,P〈0.01）; eGFR decreased gradually after PCI , but still were higher than that of the control group（Fgroup =12.880, Ftime =33.263,Finteraction =25.307,P〈0.01）.CIN incidence in treatment group was 3.7%,lower than that of the control group 16.3%（χ2 =7.351,P=0.007）.After PCI, the plasma BNP level was reduced in treatment group, but increased obviously in control group compared with before PCI （Fgroup =9.148, Ftime =4.745, Finteraction =216.413,P〈0.05）; LVEF increased and LVEDD was reduced gradually in treatment group after PCI , while LVEF decreased and LVEDD increased in control group 1 d after PCI compared with those before PCI , and restored to the normal level 7 day after PCI （ LVEF：Fgroup =7.497,Ftime =3.740,Finteraction =118.041,P〈0.05;LVEDD：Fgroup =19.116, Ftime =5.782,Finteraction =106.593,P〈0.05）.Conclusion： rhBNP combined with hydration can not only improve cardiac function of patients with CHF , but also reduce the CIN incide
出处
《郑州大学学报（医学版）》
CAS
北大核心
2014年第6期852-856,共5页
Journal of Zhengzhou University(Medical Sciences)
关键词
造影剂肾病
B型钠尿肽
慢性充血性心力衰竭
经皮冠状动脉介入治疗
contrast induced nephropathy
B-type natriuretic peptide
chronic congestive heart failure
percutaneous coronary intervention
