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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年04期

页码:

340-345

栏目:

临床医学

出版日期:

2020-07-15

文章信息/Info

Title:

Effect of recombinant human B-type natriuretic peptide in preventing contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

文章编号:

1006-8147(2020)04-0340-06

作者:

张昊; 李广平; 陈康寅

（天津市心血管病离子与分子机能重点实验室，天津医科大学第二医院心脏科，天津心脏病学研究所，天津 300211）

Author(s):

ZHANG Hao; LI Guang-ping; CHEN Kang-yin

（Department of Cardiology,The Second Hospital，Tianjin Medical University, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,Tianjin 300211, China）

关键词:

急性心肌梗死; 冻干重组人脑利钠肽; 急诊经皮冠状动脉介入治疗; 对比剂肾病; 对比剂

Keywords:

acute myocardial infarction; recombinant human B-type natriuretic peptide; primary percutaneous coronary intervention; contrast-induced nephropathy; contrast media

分类号:

R541.4

DOI:

-

文献标志码:

A

摘要:

目的：探讨急性心肌梗死患者接受急诊经皮冠状动脉介入治疗（PCI）后，新活素（冻干重组人脑利钠肽）对于对比剂肾病（CIN）的预防及肾功能的保护作用。方法：将88例急性心肌梗死接受急诊PCI治疗的患者随机分为试验组（45例）和对照组（43例），急诊PCI术后试验组即刻开始应用冻干重组人脑利钠肽0.007 5～0.015 μg/（kg·min），持续48～72 h，试验组及对照组术后均接受0.9%氯化钠生理盐水1 mL/（kg·min）持续水化治疗维持至术后12～24 h，分别于术前及术后48、72 h测定血清肌酐（SCr）、血清胱抑素C（Cys C）。结果：试验组PCI术后72 h较基线的SCr及估算的肾小球滤过率（eGFR）差值显著低于对照组（Scr升高值：5.33 vs.17.93, P=0.020；eGFR降低值：4.24 vs.12.18, P=0.008），同时试验组CIN发生率较对照组明显降低（P=0.042），Logistic回归分析显示应用冻干重组人脑利钠肽为CIN的保护因素（OR=0.04，95%CI：0.00～0.36）。结论：对于急性心肌梗死行急诊PCI治疗后应用冻干重组人脑利钠肽可保护肾功能，减少对比剂肾病发生率。

Abstract:

Objective: To evaluate the effect of recombinant human B-type natriuretic peptide(rhBNP)in preventing contrast-induced nephropathy(CIN) in patients undergoing primary percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI). Methods: We enrolled 88 patients with AMI undergoing primary PCI. The patients were divided into two groups: experimental group(n=45)and control group(n=43). The patients in rhBNP group received rhBNP 0.007 5-0.015 μg/（kg·min）immediately after primary PCI, and this therapy lasted 48-72 hours.The rhBNP group and the control group were treated with 0.9% sodium chloride of normal saline with 1 mL/(kg·min) for 12 to 24 hours. Serum creatinine(SCr) and cystatin C(Cys C) were measured before and 48 and 72 hours after primary PCI. Results: Compared with control group, SCr and estimated glomerular filtration rate(eGFR) before and 72 hours after primary PCI, the SCr rising and eGFR reducing in experimental group was significantly lower(SCr rising: 5.33 vs. 17.93, P=0.020, eGFR reducing: 4.24 vs. 12.18, P=0.008). The incidence of CIN in experimental group was lower than that in control group(6 vs. 14, P=0.042). Logistic regression analysis of risk factors of CIN showed using rhBNP was a protective factor(OR=0.04，95%CI:0.00-0.36). Conclusion: RhBNP has the effect on renal function protection in patients with AMI undergoing primary PCI, and it can also reduce the incidence of CIN.

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备注/Memo

备注/Memo:

作者简介 张昊（1987-），男，硕士，医师，研究方向：冠心病临床研究；
通信作者：李广平， E-mail：tjcardiol@126.com。

常用功能

更新日期/Last Update: 2020-07-15