摘要
目的探讨烟酸预防老年人冠脉介入术后造影剂肾病(CIN)作用。方法选取2019年9月—2020年11月赣州市立医院收治的150例冠脉介入老年患者作为研究对象,按照随机数字表法分为A组、B组和C组,每组各50例。A组为空白对照组,B组予以中剂量(40 mg)烟酸治疗,C组予以高剂量(80 mg)烟酸治疗。比较三组CIN发生率、肾功能指标、血清C-反应蛋白(CRP)和超氧化物歧化酶(SOD)水平及不良反应发生情况。结果A、B、C组CIN发生率分别为16.00%(8/50)、4.00%(2/50)、2.00%(1/50),B、C组CIN发生率均低于A组,差异有统计学意义(P<0.05)。术后1、3 d,B、C组血清肌酐(Scr)、尿素氮(BUN)、尿酸(UA)、CRP水平低于A组,血清SOD水平高于A组,差异有统计学意义(P<0.05);术后1 d,C组血清SCr、CRP水平低于B组,差异有统计学意义(P<0.05)。A、B、C组不良反应总发生率分别为4.00%(2/50)、12.00%(6/50)、28.00%(14/50),A组不良反应总发生率低于C组,差异有统计学意义(P<0.017)。结论老年人在冠脉介入术术前24 h至术后72 h给予烟酸40 mg bid静脉输注可降低CIN发生率,改善介入术后肾功能、炎症因子及氧化应激反应。
Objective To explore the effect of Niacin on prevention of contrast-induced nephropathy(CIN)in elderly patients after coronary intervention.Methods A total of 150 elderly patients with coronary intervention admitted to Ganzhou Municipal Hospital from September 2019 to November 2020 were selected as the research objects and divided into group A,group B and group C according to random number table method,with 50 patients in each group.Group A was the blank control group,group B was treated with medium dose(40 mg)of Niacin,and group C was treated with high dose(80 mg)of Niacin.The incidence of CIN,renal function indexes,serum C-reactive protein(CRP)and superoxide dismutase(SOD)levels and the incidence of adverse events were compared among the three groups.Results The incidence of CIN in group A,B and C was 16.00%(8/50),4.00%(2/50)and 2.00%(1/50),respectively.The incidence of CIN in group B and C was lower than that in group A,and the differences were statistically significant(P<0.05).On postoperative day 1 and 3,the serum creatinine(SCR),blood urea nitrogen(BUN),uric acid(UA)and CRP levels in groups B and C were lower than those in group A,and the serum SOD level was higher than that in group A,and the differences were statistically significant(P<0.05).On postoperative day 1,serum SCR and CRP levels in group C were lower than those in group B,and the differences were statistically significant(P<0.05).The total incidence of adverse events in group A,B and C was 4.00%(2/50),12.00%(6/50)and 28.00%(14/50),respectively.The total incidence of adverse reactions in group A was lower than that in group C,and the differences was statistically significant(P<0.017).Conclusion Intravenous infusion of Niacin 40 mg bid 24 h before and 72 h after coronary intervention in the elderly can reduce the incidence of CIN,improve renal function,inflammatory factors and oxidative stress response after coronary intervention.
作者
张科飞
江人桂
张必龙
ZHANG Ke-fei;JIANG Ren-gui;ZHANG Bi-long(Department of Pharmacy,Ganzhou Municipal Hospital,Jiangxi Province,Ganzhou341000,China)
出处
《中国当代医药》
CAS
2021年第19期158-161,共4页
China Modern Medicine
基金
江西省赣州市指导性科技计划项目(GZ2020ZSF415)。
关键词
烟酸
冠脉介入术
造影剂肾病
预防
Niacin
Percutaneous coronary intervention
Contrast-induced nephropathy
Prevention
