| 重组人B型脑利钠肽对急性心肌梗死患者急诊经皮冠状动脉介入治疗后对比剂肾病的预防作用 |
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| 引用本文： | 张昊,李广平,陈康寅.重组人B型脑利钠肽对急性心肌梗死患者急诊经皮冠状动脉介入治疗后对比剂肾病的预防作用[J].天津医科大学学报,2020,0(4):340-345. |
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| 作者姓名： | 张昊 李广平 陈康寅 |
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| 作者单位： | （天津市心血管病离子与分子机能重点实验室，天津医科大学第二医院心脏科，天津心脏病学研究所，天津 300211） |
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| 摘 要： | 目的:探讨急性心肌梗死患者接受急诊经皮冠状动脉介入治疗（PCI）后，新活素（冻干重组人脑利钠肽）对于对比剂肾病（CIN）的预防及肾功能的保护作用。方法:将88例急性心肌梗死接受急诊PCI治疗的患者随机分为试验组（45例）和对照组（43例），急诊PCI术后试验组即刻开始应用冻干重组人脑利钠肽0.007 5～0.015 μg/（kg·min），持续48～72 h，试验组及对照组术后均接受0.9%氯化钠生理盐水1 mL/（kg·min）持续水化治疗维持至术后12～24 h，分别于术前及术后48、72 h测定血清肌酐（SCr）、血清胱抑素C（Cys C）。结果:试验组PCI术后72 h较基线的SCr及估算的肾小球滤过率（eGFR）差值显著低于对照组（Scr升高值:5.33 vs.17.93, P=0.020；eGFR降低值:4.24 vs.12.18, P=0.008），同时试验组CIN发生率较对照组明显降低（P=0.042），Logistic回归分析显示应用冻干重组人脑利钠肽为CIN的保护因素（OR=0.04，95%CI:0.00～0.36）。结论:对于急性心肌梗死行急诊PCI治疗后应用冻干重组人脑利钠肽可保护肾功能，减少对比剂肾病发生率。
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| 关 键 词： | 急性心肌梗死 冻干重组人脑利钠肽 急诊经皮冠状动脉介入治疗 对比剂肾病 对比剂 |
Effect of recombinant human B-type natriuretic peptide in preventing contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction |
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| ZHANG Hao,LI Guang-ping,CHEN Kang-yin.Effect of recombinant human B-type natriuretic peptide in preventing contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction[J].Journal of Tianjin Medical University,2020,0(4):340-345. |
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| Authors: | ZHANG Hao LI Guang-ping CHEN Kang-yin |
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| Affiliation: | （Department of Cardiology,The Second Hospital，Tianjin Medical University, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,Tianjin 300211, China） |
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| Abstract: | Objective: To evaluate the effect of recombinant human B-type natriuretic peptide(rhBNP)in preventing contrast-induced nephropathy(CIN) in patients undergoing primary percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI). Methods: We enrolled 88 patients with AMI undergoing primary PCI. The patients were divided into two groups: experimental group(n=45)and control group(n=43). The patients in rhBNP group received rhBNP 0.007 5-0.015 μg/（kg·min）immediately after primary PCI, and this therapy lasted 48-72 hours.The rhBNP group and the control group were treated with 0.9% sodium chloride of normal saline with 1 mL/(kg·min) for 12 to 24 hours. Serum creatinine(SCr) and cystatin C(Cys C) were measured before and 48 and 72 hours after primary PCI. Results: Compared with control group, SCr and estimated glomerular filtration rate(eGFR) before and 72 hours after primary PCI, the SCr rising and eGFR reducing in experimental group was significantly lower(SCr rising: 5.33 vs. 17.93, P=0.020, eGFR reducing: 4.24 vs. 12.18, P=0.008). The incidence of CIN in experimental group was lower than that in control group(6 vs. 14, P=0.042). Logistic regression analysis of risk factors of CIN showed using rhBNP was a protective factor(OR=0.04，95%CI:0.00-0.36). Conclusion: RhBNP has the effect on renal function protection in patients with AMI undergoing primary PCI, and it can also reduce the incidence of CIN. |
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| Keywords: | acute myocardial infarction recombinant human B-type natriuretic peptide primary percutaneous coronary intervention contrast-induced nephropathy contrast media |
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