内科

目的探讨百令胶囊联合前列地尔干预预防冠状动脉介入术（PCI）后造影剂肾病的临床效果。方法选取在我院行PCI治疗的患者102例，采用随机数字表法分为对照组和观察组，每组51例。两组患者均接受PCI治疗，均使用碘海醇作为造影剂，对照组患者于PCI术前、当日及术后3 d给予前列地尔干预各1次；观察组患者在对照组干预的基础上于PCI术前、当日及术后3 d加服百令胶囊，6粒/次，1次/d。术后3 d，比较两组患者的肾功能、氧化应激状况、造影剂肾病发生情况以及临床不良事件发生率。结果术后3 d，两组患者的血肌酐（Cr）、尿素氮（BUN）水平显著升高（P＜0.05），肾小球滤过率（GFR）水平显著降低（P＜0.05），观察组患者的Cr、BUN水平显著低于对照组，GFR水平显著高于对照组（P＜0.05）；两组患者的超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-PX）水平均显著降低，丙二醛（MDA）水平显著升高，观察组患者SOD、GSH-PX水平显著高于对照组，MDA水平显著低于对照组，差异有统计学意义（P＜0.05）。PCI术后观察组患者的造影剂肾病发生率（1.96%）显著低于对照组（15.69%），观察组患者的临床不良事件总发生率（15.69%）显著低于对照组（35.29%），差异有统计学意义（P＜0.05）。结论百令胶囊联合前列地尔能通过降低机体的氧化应激反应程度，减轻肾脏的毒性损伤，对PCI术后患者的肾功能具有良好的保护作用，可显著降低患者造影剂肾病的发生率。

ObjectiveTo investigate the efficacy of Bailing capsule combined with alprostadil to prevent contrast-induced nephropathy after percutaneous coronary intervention (PCI). Methods102 cases treated with PCI in our hospital were selected and randomly divided into control group and observation group, with 51 cases in each group. All cases were given with PCI and Iodohexanol contrast agent. Control group were treated with alprostadil (qd) pre-operation, operation day and 3 d after operation respectively. On basis of the therapeutic method of control group, observation group were given with Bailing capsule (once 6 grains, tid) pre-operation, operation day and 3 days after operation respectively. 3 days after operation, renal function, oxidative stress, incidence of contrast-induced nephropathy and incidence of clinical adverse events were compared between the two groups. ResultsAt 3 days after operation, the levels of serum creatinine(Cr) and blood urea nitrogen(BUN) in the two groups were significantly increased（P＜0.05）, and the level of glomerular filtraion rate(GFR) was significantly decreased (P＜0.05); the levels of Cr and BUN in the observation group were significantly lower than those in the control group, and the GFR level was significantly higher than that in the control group (P＜0.05). At 3 days after operation, the levels of superoxide dismutase(SOD) and glutathione peroxidase(GSH-PX) in the two groups were obviously increased, while malondialde hyde(MDA) was remarkably decreased. The levels of SOD and GSH-PX in the observation group were significantly higher than those in the control group, and the MDA level was significantly lower than that in the control group (P＜0.05). The incidence of contrast-induced nephropathy for observation group was 1.96%, which was remarkably less than control group as 15.69%. The incidence of clinical adverse events for observation group(15.69%) was lower than control group(35.29%), the difference is statistically significant (P＜0.05). ConclusionBailing capsule combined with alprostadil can improve the oxidative stress level, reduce the toxic damage of kidney, and restore the renal function of patients after PCI, which can significantly reduce the incidence of contrast-induced nephropathy in patients.