摘要
目的探讨血清胱抑素C（Cys—C）对于冠脉介入手术后对比剂肾病（CIN）的评价作用以及依那普利对CIN的治疗效果。方法将86例行冠脉造影术或经皮冠状动脉支架置入术的患者随机分为观察组和对照组，检测血清Cys-C以及血清肌酐（Scr）浓度，所有患者在介入手术前后行水化疗法，观察组患者在此基础上加用依那普利治疗。观察并记录介入手术前后血清Cys—C、Scr以及肾小球滤过率（eGFR）的变化，以及治疗效果。结果观察组患者术后血清中Cys-C、Scr以及eGFR与介入手术前差异均无统计学意义（均P〉0．05），尿素氮（BUN）术后浓度为（3．964-0．89）mmol／L，较介入手术前为低（P〈0．05），CIN1例，发生率为2．33％。而对照组患者术后血清中Cys—C浓度为（18．4±0．58）mg／L，较术前明显升高（P〈0．05），Scr、eGFR以及BUN与介入手术前差异均无统计学意义（均P〉0．05），CIN5例，发生率为11．63％。结论Cys—C对比剂肾病的早期检测较传统的Scr敏感，且检验较为方便。介入手术前后使用依那普利能有效减少CIN的发生率。
Objective To investigate the evaluation of serum cystatin C and treating efficacy of enalapril for contrast induced nephropathy after percutaneous coronary intervention. Methods 86 patients who need coronary angi- ography or coronary stents implantation by skin were divided into observation group （43 cases） and control group（43 cases） randomly. The fasting venous blood was extracted and in which Cys-C and Scr were tested. All the patients were given water therapy, and enalapril was added in observation group. Diversification of concentration of Cys-C and Scr and efficacy of enalapril were recorded. Results There was no difference of Cys-C and Scr in serum and eGFR before and after operation（ all P 〉0.05 ） ,and the concentration of BUN was （3.96 ± 0.89）mmoL/L,which was lower after operation（P 〈0.05） ,and the rate of CIN incidence was 2.33% （ 1 case）. The concentration of Cys-C in serum was （ 18.4 ±0.58 ） mg/L, which was significantly higher than preoperation （ P 〈 0.05 ） , and there was no significant difference of Scr, eGFR and BUN before and after operation（ P 〉 0.05 ） , and the rate of CIN incidence was 11.63% （5 cases）. Conclusion Cys-C was more sensitive in early detection for contrast induced nephropathy and more con- venient. The rate of CIN incidence could be decreased by using enalapril.
出处
《中国基层医药》
CAS
2012年第23期3521-3522,共2页
Chinese Journal of Primary Medicine and Pharmacy
