左卡尼汀联合水化对伴有肾功能不全的冠心病患者造影剂肾病的预防作用研究

目的探讨左卡尼汀联合水化对伴有肾功能不全的冠状动脉粥样硬化性心脏病(冠心病)患者造影剂肾病的预防作用。方法选取于2018年6月至2019年12月于河南大学第一附属医院行择期冠状动脉(冠脉)造影术或冠脉支架植入术的肾功能不全的冠心病患者,将入组患者按照治疗方法分为左卡尼汀联合水化组(n=51)和单纯水化组(n=57)。比较两组术后48 h造影剂肾病的发生率,测定两组术前和术后6 h中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及术后48 h血肌酐、肾小球滤过率(eGFR)水平。结果左卡尼汀联合水化组造影剂肾病的发生率(9.80%)低于单纯水化组(24.73%),差异有统计学意义(P<0.05)。左卡尼汀联合水化组术后6 h NGAL及48 h肌酐水平低于单纯水化组,eGFR的水平高于单纯水化组,差异有统计学意义(P均<0.05)。结论左卡尼汀联合水化可降低伴有肾功能不全的冠心病患者造影剂肾病的发生率。

Preventive effect of L-carnitine combined with hydration on contrast-medium nephropathy in patients with coronary heart disease with renal insufficiency

Objective To explore the preventive effect of L-carnitine combined with hydration on contrastmedium nephropathy in patients with coronary heart disease with renal insufficiency.Methods Patients with coronary artery disease with renal insufficiency performed in selective coronary angiography or coronary stent implantation in the First Affiliated Hospital of Henan University from June 2018 to December 2019 were divided into levocarnitine combined hydration group(n=51)and simple hydration group(n=57)according to the treatment.The incidence of postoperative 48-hour contrast-induced nephropathy in the two groups was compared,preoperative and postoperative 6-hour levels of neutrophil gelatinase-associated lipocalin(NGAL)and 48-hour levels of serum creatinine and glomerular filtration rate(eGFR)were measured in the two groups.Results The incidence of contrast-induced nephropathy in levocarnitine combined hydration group(9.80%)was lower than that in simple hydration group(24.73%),and the difference was statistically significant(P<0.05).The levels of NGAL at 6-hour and creatinine at 48-hour in levocarnitine combined hydration group were lower than those in simple hydration group after operation,and the level of eGFR was higher than that in simple hydration group(all P<0.05).Conclusion Levocarnitine combined with hydration can reduce the incidence of contrast-induced nephropathy in patients with coronary heart disease with renal insufficiency.