补肾活血方对对比剂诱导的急性肾损伤患者不同标志物水平的影响

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摘要目的考察补肾活血方对对比剂诱导的急性肾损伤（CIAKI）患者不同标志物水平的影响。方法选取2016年10月～2018年1月在西电集团医院就诊的先后已行冠状动脉增强CT和经皮冠状动脉介入治疗（PCI）的患者243例为研究对象，按照随机数字表法将其分为两组，观察组119例，对照组124例。对照组给予0.9%氯化钠注射液静脉滴注水化治疗，观察组在对照组的基础上给予补肾活血方。比较两组治疗前后外周血胱抑素C（Cys C）、尿素氮（BUN）、血肌酐（Scr）、肌酐清除率（Ccr）、超氧化歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、肿瘤坏死因子-α（TNF-α）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）、人肾损伤分子1（KIM-1）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平，并记录两组患者PCI术后72 h内发生CIAKI的情况。结果两组患者治疗后外周血Cys C、BUN、Scr、TNF-α、CRP、IL-6、KIM-1和NGAL均高于治疗前（P ＜ 0.05），Ccr、SOD和GSH-Px均低于治疗前（P ＜ 0.05）。治疗后，观察组外周血Cys C、BUN、Scr、TNF-α、CRP、IL-6、KIM-1和NGAL均低于对照组（P ＜ 0.05），Ccr、SOD和GSH-Px均高于对照组（P ＜ 0.05）。观察组CIAKI发生率（4.20%）显著低于对照组（11.29%）（P ＜ 0.05）。结论补肾活血方干预有助于降低PCI及增强CT检查相关的CIAKI，与改善标志物相关。

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	范丽1 董正华2 杨海霞1 王瑞3

关键词 ：补肾活血方, 经皮冠状动脉介入治疗, 增强CT, 对比剂, 急性肾损伤

Abstract：Objective To investigate the effect of Bushen Huoxue Recipe on different markers in patients with contrast induced acute kidney injury (CIAKI). Methods A total of 243 patients underwent coronary artery enhanced CT and percutaneous coronary intervention (PCI) were enrolled in Xi′an Xidian Group Hospital from October 2016 to January 2018. According to the random number table method, they were randomly divided into two groups: 119 cases in the observation group and 124 cases in the control group. The control group was given 0.9% Sodium Chloride Injection by intravenous drip irrigation, and the observation group was given Bushen Huoxue Recipe based on the treatment of control group. The cystatin c (Cys C), blood urea nitrogen (BUN), serum creatinine (Scr), creatinine clearance rate (Ccr), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), keyboard input monitor-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in blood before and after treatment in the two groups were recorded and compared. The incidence of CIAKI within 72 h after PCI was recorded in the two groups. Results The levels of peripheral blood Cys C, BUN, Scr, TNF-α, CRP, IL-6, KIM-1 and NGAL of the two groups were higher than those before treatment (P ＜ 0.05), and Ccr, SOD and GSH-Px were lower than those before treatment (P ＜ 0.05). After treatment, the levels of peripheral blood Cys C, BUN, Scr, TNF-α, CRP, IL-6, KIM-1 and NGAL in the observation group were lower than those in the control group (P ＜ 0.05), and Ccr, SOD and GSH-Px were higher than those of the control group (P ＜ 0.05). The incidence of CIAKI in the observation group (4.20%) was significantly lower than the control group (11.29%) (P ＜ 0.05). Conclusion Bushen Huoxue Recipe can help reduce PCI and enhance CT-related CIAKI, which is associated with improved markers.

Key words： Bushen Huoxue Recipe Percutaneous coronary intervention Enhanced CT Contrast Acute kidney injury

基金资助:陕西省卫生科研项目立项项目（2016JLJS0095）。

通讯作者: 王瑞（1981.5-），女，硕士；研究方向：内科常见病。

作者简介: 范丽（1981.4-），女，硕士；研究方向：中西医结合肾脏病。

引用本文:

范丽1 董正华2 杨海霞1 王瑞3. 补肾活血方对对比剂诱导的急性肾损伤患者不同标志物水平的影响[J]. 中国医药导报, 2018, 15(28): 125-129.
FAN Li1 DONG Zhenghua2 YANG Haixia1 WANG Rui3. Effect of Bushen Huoxue Recipe on different markers in patients with contrast induced acute kidney injury. 中国医药导报, 2018, 15(28): 125-129.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I28/125

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