乌司他丁对糖尿病肾脏疾病患者冠状动脉造影术后的肾保护作用

目的 探讨乌司他丁对糖尿病肾脏疾病（diabetic kidney disease,DKD）患者冠状动脉造影术后的肾脏保护作用.方法 募集因反复心绞痛需行冠状动脉造影术的DKD患者43例,随机分为治疗组（n=23）和对照组（n=20）.从造影前12 h至造影后12h,2组均用0.9％氯化钠注射液静脉滴注水化,不同之处为治疗组自造影当天开始每日静滴乌司他丁20万单位,而对照组仅静滴0.9％氯化钠注射液100ml,疗程均为7d.分别于造影前及造影后1、3、7d留取2组患者的外周血标本,利用生化仪检测2组患者血肌酐（SCr）及血胱抑素C（Cys C）水平.结果 ①2组患者冠状动脉造影术后其外周血中SCr及Cys C的值均升高;②治疗组患者外周血中SCr及CysC于第3天及第7天升高幅度显著低于对照组（P＜0.05）,且差异有统计学意义.结论 乌司他丁能降低DKD患者行冠状动脉造影术后SCr及CysC升高幅度,具有肾脏保护作用.

Renal protective effects of ulinastatin in diabetic kidney disease patients after coronary angiography

Objective To investigate the renal protective effects of ulinastatin in diabetic kidney disease patients after coronary angiography. Methods Forty-three cases of diabetic nephropathy were divided randomly into two groups： experimental group （n = 23） and control group （n = 20）. All pa- tients were subjected to coronary angiography because of intractable angina. The patients in both two groups were intravenously dripped with normal saline for hydration from 12 h before coronary angiog- raphy to 12 h after coronary angiography. The experimental group was given ulinastatin of 2. 0 105 U every day after coronary angiography, and the control group was given normal saline. Treatment peri- od was 7 days. The serum creatinine （SCr） and cystatin C （Cys C） levels were determined before and at day 1, 3 and 7 after coronary angiography. Results （I） SCr and Cys C levels in two groups were both increased after coronary angiography; （1） The increased extent of SCr and Cys C in experiment group was significantly lower than in control group （P0. 05）. Conclusions Ulinastatin can more ef- fectively decrease levels of SCr and Cys C in diabetic kidney disease patients after coronary angiography and play the role of protecting the kidney.