摘要
目的 研究黄蜀葵花制剂预防造影剂肾病的效果及作用机制。方法 采用单中心、非盲法、随机对照研究,将南京中医药大学附属医院2021年7月1日—11月1日收治的60例拟行冠状动脉介入术的患者随机分为治疗组和对照组各30例。对照组予标准基础治疗(阿司匹林、他汀类、硝酸酯类、β受体拮抗剂、血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体拮抗剂等),治疗组在对照组治疗基础上于术前24 h至术后48 h给予黄蜀葵花制剂口服。比较2组患者造影剂肾病发生率,观察2组术前24 h及术后48 h尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清白细胞介素-1β(IL-1β)、胱抑素C(CysC)、血肌酐(SCr)、尿素氮(BUN)水平变化。结果 治疗组和对照组的造影剂肾病发生率分别为0和13.33%(4/30),治疗组明显低于对照组(P<0.05)。术前24 h, 2组尿NGAL及血清IL-1β、CysC、SCr、BUN水平比较差异均无统计学意义(P均>0.05);术后48 h,对照组尿NGAL及血清IL-1β、CysC、SCr、BUN水平均较术前24 h明显升高(P均<0.05),治疗组尿NGAL水平较术前24 h明显降低(P<0.05),血清IL-1β、CysC、SCr、BUN水平与术前24 h比较差异均无统计学意义(P均>0.05);治疗组术后48 h尿NGAL及血清IL-1β、CysC、SCr、BUN水平均明显低于对照组(P均<0.05)。结论 黄蜀葵花制剂可以预防冠状动脉介入术后造影剂肾病的发生,推测其作用机制可能与抑制炎症反应相关。
Objective It is to study the effect and action mechanism of Astragalus manihot preparations in preventing contrast nephropathy.Methods A single center,unblinded,randomized controlled study was conducted to randomly divide 60 patients who were admitted to the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from July 1 to November 1,2021 and undergoing coronary intervention into treatment group and control group,with 30 patients in each group.The control group received standard basic treatment(aspirin,statins,nitrates,βreceptor antagonists,angiotensin-converting enzyme inhibitors or angiotensinⅡreceptor antagonists),the treatment group was given Astragalus manihot preparations orally from 24 hours before operation to 48 hours after operation on the basis of treatment in the control group.The incidence of contrast agent nephropathy was compared between the two groups,and the changes in the levels of urinary neutrophil gelatinase associated lipid transporter(NGAL)and serum interleukin-1β(IL-1β),cystatin C(CysC),creatinine(SCR)and blood urea nitrogen(BUN)24 hours before operation and 48 hours after operation were observed in the two groups.Results The incidence of contrast nephropathy in the treatment group and the control group was 0%and 13.33%(4/30),respectively,which was significantly lower in the treatment group than that in the control group(P<0.05).There was no significant difference in the levels of urine NGAL and serum IL-1β,CysC,SCr and BUN at 24 hours before operation between the two groups(P>0.05);at 48 hours after operation,the levels of urine NGAL and serum IL-1β,CysC,SCr and BUN in the control group were significantly higher than those at 24 hours before operation(all P<0.05),the urine NGAL level in the treatment group was significantly lower than that at 24 hours before operation(P<0.05),the levels of serum IL-1β,CysC,SCr and BUN had no significant difference compared with those at 24 hours before operation(all P>0.05).The levels of urine NGAL and serum IL-1β,CysC,SCr
作者
刘俊红
林欣
缪晓帆
牛茹歌
戴友平
LIU Junhong;LIN Xin;LIAO Xiaofan;NIU Ruge;DAI Youping(The Affiliated Hospital of Nanjing University of Tradition Chinese Medicine,Nanjing 210029,Jiangsu,China)
出处
《现代中西医结合杂志》
CAS
2022年第19期2652-2656,2669,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
国家自然科学基金资助项目(81973762)。
关键词
黄蜀葵花制剂
经皮冠脉介入治疗
造影剂肾病
肾损伤指标
Astragalus manihot preparations
percutaneous coronary intervention
contrast nephropathy
renal injury index
