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脂质体携载前列腺素E1对冠心病合并糖尿病患者发生造影剂肾病的预防作用
引用本文:朱莉,阮中宝,殷屹岗,王如珠,林杰,任寅,陈铭,王斌,陈各才,高琳琳,朱俊国.脂质体携载前列腺素E1对冠心病合并糖尿病患者发生造影剂肾病的预防作用[J].中华老年医学杂志,2011,30(10).
作者姓名:朱莉  阮中宝  殷屹岗  王如珠  林杰  任寅  陈铭  王斌  陈各才  高琳琳  朱俊国
作者单位:225300,江苏省泰州市人民医院心内科
摘    要:目的 探讨脂质体携载前列腺素E1(PGE1)对冠心病合并糖尿病的患者发生造影剂肾病的预防作用.方法 选取行冠脉造影或介入治疗的合并糖尿病的冠心病患者198例,随机分为对照组和PGE1组.PGE1组在常规治疗的基础上予PGE1 20μg+生理盐水20ml静脉注射,1次/d,共10 d,比较两组造影前、造影后48 h、5d血肌酐(Scr)、尿素(BUN)、胱抑素C(CysC)水平及造影剂肾病发生率等.结果 造影后48 h、5dScr、BUN、Cys C等在PGE1组分别为(113.92±54.89)μmmol/L、(7.85±4.05)mmol/L、(1.38±0.34)mg/L和(86.72±35.26)μmmol/L、(6.61±3.09 )mmol/L、(1.29±0.29)mg/L优于对照组(129.22±50.18)μmmol/L、(9.26±3.95) mmol/L、(1.56±0.23)mg/L和(109.83±31.76)μmmol/L、(8.07±3.11)mmol/L、(1.37±0.21)mg/L,差异有统计学意义(均P<0.05).经直线相关分析,造影剂剂量与BUN、Scr呈显著正相关(r=0.74,P<0.05; r=0.82,P<0.01).结论 PGE1对冠心病合并糖尿病的患者发生造影剂肾病有预防作用.

关 键 词:前列腺素E1  冠心病  糖尿病  2型  造影剂

Preventive effect of prostaglandin E1 on contrast medium-induced nephropathy in patients with coronary disease combined with diabetes mellitus
ZHU Li,RUAN Zhong-bao,YIN Yi-gang,WANG Ru-zhu,LIN Jie,REN Yin,CHEN Ming,WANG Bin,CHEN Ge-cai,GAO Lin-lin,ZHU Jun-guo.Preventive effect of prostaglandin E1 on contrast medium-induced nephropathy in patients with coronary disease combined with diabetes mellitus[J].Chinese Journal of Geriatrics,2011,30(10).
Authors:ZHU Li  RUAN Zhong-bao  YIN Yi-gang  WANG Ru-zhu  LIN Jie  REN Yin  CHEN Ming  WANG Bin  CHEN Ge-cai  GAO Lin-lin  ZHU Jun-guo
Abstract:Objective To study whether prostaglandin E1 (LipoPGE1) could prevent contrast medium-induced nephropathy (CIN) in patients with coronary heart disease (CHD) plus diabetes mellitus type 2 (DM).Methods Total 198 CHD patients with DM received coronary angiography (CAG) or PCI were randomly divided into PGE1 group and control group.All patients received routine treatment,and the PGE1 group also received 20 ml normal saline and 20 μg PGE1 (intravenous injection,1 time/d) for 10 days.The rate of CIN and the level of serum urea nitrogen (BUN),creatinine (Scr),cystatin C (Cys C) were measured before and 48 hours and 5 days after contrastmedium administration.Results The level of Scr,BUN and Cys C were lower in PGE1 group (113.92±54.89)μmmol/ L,(7.85±4.05)mmol/L,(1.38±0.34)mg/L]for 48 hours and(86.72±35.26)μmmol/L,(6.61 ± 3.09 ) mmol/L,( 1.29 ± 0.29) mg/L]for 5 days than in control group (129.22±50.18)μmmol/L,(9.26±3.95)mmol/L,(1.56±0.23)mg/L]for 48 hours and(109.83+31.76)μmmol/ L,(8.07±3.11)mmol/L,(1.37±0.21)mg/L]for 5 days (all P<0.05).The dose of contrast-medium was positively correlated with the level of Scr and BUN (r=0.74,P<0.05 and r =0.82,P<0.01,respectively).The patients' renal function in the PGE1 group was better than in control group after contrast-medium administration (P <0.05).BUN and Scr were positively correlated with the volume of contrast-medium (r=0.74,P<0.05,r=0.82,P<0.01).Conclusions PGE1 may prevent contrast medium-induced nephropathy in patients with CHD combined with DM.
Keywords:Prostaglandin E1  Coronary disease  Diabetes mellitus  type 2  Contrast media
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