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[1]万瑜,英硕,张鹏,等.复方丹参滴丸对肾功能异常患者对比剂引发的急性肾损伤的保护作用[J].天津医科大学学报,2024,30(05):429-433.[doi:10.20135/j.issn.1006-8147.2024.05.0429]
　WAN Yu,YING Shuo,ZHANG Peng,et al.Protective effect of compound Danshen dropping pills on contrast-induced acute kidney injury in patients with renal dysfunction[J].Journal of Tianjin Medical University,2024,30(05):429-433.[doi:10.20135/j.issn.1006-8147.2024.05.0429]
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复方丹参滴丸对肾功能异常患者对比剂引发的急性肾损伤的保护作用(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
30卷
期数:
2024年05期
页码:
429-433
栏目:
临床医学
出版日期:
2024-09-25

文章信息/Info

Title:
Protective effect of compound Danshen dropping pills on contrast-induced acute kidney injury in patients with renal dysfunction
文章编号:
1006-8147（2024）05-0429-05
作者:
万瑜1; 英硕2; 张鹏2; 赵智程2; 付乃宽2
（1.天津医科大学胸科临床学院，天津 300222；2.天津市胸科医院心内三科，天津 300222）
Author(s):
WAN Yu1; YING Shuo2; ZHANG Peng2; ZHAO Zhicheng1; FU Naikuan2
（1.Clinical College of Thoracic Medicine，Tianjin Medical University，Tianjin 300222，China； 2.The Third Department of Cardiovascular Medicine，Tianjin Chest Hospital，Tianjin 300222，China）
关键词:
复方丹参滴丸; 肾功能异常; 对比剂; 急性肾损伤; 经皮冠状动脉介入术
Keywords:
compound Danshen dropping pills; renal dysfunction; contrast agent; acute kidney injury; percutaneous coronary intervention
分类号:
R541.4+R256.5
DOI:
10.20135/j.issn.1006-8147.2024.05.0429
文献标志码:
A
摘要:
目的：探讨复方丹参滴丸对肾功能异常患者经皮冠状动脉介入治疗（PCI）后对比剂引发的急性肾损伤（CIAKI）的作用。方法：入选天津市胸科医院心内科2019年1月—2021年12月拟行PCI的肾功能异常冠心病患者590例，采用完全随机化法将其分为对照组和复方丹参滴丸组，各295例，分别给予水化、水化联合口服复方丹参滴丸（术前 1 d起，每日 3 次，每次 10 粒）治疗。观察并比较 2 组入院时和对比剂使用后 72 h肌酐（Cr） 、尿素氮（BUN）、尿白蛋白、肾小球滤过率（GFR）、白细胞介素（IL）-6、超敏C反应蛋白（hs-CRP）、β2微球蛋白和肿瘤坏死因子（TNF）水平，并记录两组CIAKI发生率。结果：两组术前各项观察指标差异均无统计学意义（均P＞0.05），术后复方丹参滴丸组GFR显著高于对照组（t=-6.621，P＜0.01），其余观察指标均显著低于对照组（t=2.662~6.924；U=28 942.500，均P<0.01），CIAKI的发生率也显著低于对照组（1.36% vs. 9.83%，χ2=20.061，P＜0.01）。多因素Logistic回归分析表明，复方丹参滴丸对CIAKI有保护作用（OR=0.123，95%CI：0.042~0.360，P＜0.01）。结论：复方丹参滴丸对肾功能异常患者PCI后CIAKI的发生有一定的保护作用。
Abstract:
Objective：To investigate the effect of compound Danshen dripping pills on contrast-induced acute kidney injury（CIAKI） in patients with renal dysfunction after percutaneous coronary intervention（PCI）. Methods：A total of 590 patients with coronary heart disease and renal dysfunction who were planned to undergo PCI in the department of cardiology of Tianjin Chest Hospital from January 2019 to December 2021 were selected. They were divided into control group and compound Danshen dripping pill group using complete randomization method，with 295 cases in each group. They were treated with hydration and hydration combined with oral administration of compound Danshen dripping pill（starting from the day before surgery，3 times a day，10 pills each time）. Creatinine（Cr），blood urea nitrogen（BUN），urinary protein，glomerular filtration rate（GFR），interleukin（IL）-6，high-sensitivity C-reactive protein（hs-CRP），β2 microglobulin and tumor necrosis factor（TNF） were observed and compared between the two groups at admission and 72 h after the use of contrast agent. The occurrence of CIAKI in the two groups was recorded. Results：There was no significant difference in the preoperative observation indicators between the two groups（all P>0.05）. After surgery，the GFR of compound Danshen dripping pill group was significantly higher than that of control group（t=-6.621，P<0.01），while the other observed indicators were significantly lower than those of control group（t=2.662-6.924； U=28 942.500，all P<0.01）. The occurrence of CIAKI in the compound Danshen dripping pill group was also significantly lower than that of the control group（1.36% vs 9.83%，χ2=20.061，P＜0.01）. Multivariate Logistic regression analysis showed that compound Danshen dripping pill had protective effect on CIAKI（OR=0.123，95%CI：0.042-0.360，P＜0.01）. Conclusion：Compound Danshen dripping pills have protective effect on the occurrence of CIAKI in patients with renal dysfunction after PCI.

参考文献/References:

[1] BHATT D L. Percutaneous coronary intervention in 2018[J]. JAMA，2018，319（20）：2127-2128.
[2] 桑文涛，杨可慧，李笑，等. 造影剂肾病早期预防的研究进展[J]. 中华危重病急救医学，2019，31（9）：1174-1178.
[3] 张磊，韩雅玲，荆全民，等. 不同状态肾功能与冠心病发病率及冠状动脉病变严重程度的分析[J]. 中国介入心脏病学杂志，2012， 20（1）：4-8.
[4] 申华，秦政，周玉杰，等. 冠状动脉粥样硬化性心脏病合并慢性肾功能不全患者临床特征和经皮冠状动脉介入围术期急性肾损伤发生情况及远期预后评估[J]. 中国医药，2019，14（6）：801-805.
[5] 英硕，陈嫱，刘晓罡，等. 复方丹参滴丸对冠心病患者经皮冠状动脉介入术后对比剂肾病的预防效果及作用机制[J]. 实用心脑肺血管病杂志，2022，30（8）：96-101.
[6] 李梦兰，徐天，李全，等. 基于网络药理学探究复方丹参滴丸治疗冠状动脉粥样硬化性心脏病的作用机制[J]. 中国医药导刊，2023，25（2）：156-162.
[7] MEHRAN R，NIKOLSKY E. Contrast-induced nephropathy：definition，epidemiology，and patients at risk[J]. Kidney Int Suppl，2006（100）：S11-S15.
[8] SOLOMON R. Contrast-induced acute kidney injury（CIAKI）[J]. Radiol Clin North Am，2009，47（5）：783-788.
[9] MAMOULAKIS C，TSAROUHAS K，FRAGKIADOULAKI I，et al. Contrast-induced nephropathy：basic concepts，pathophysiological implications and prevention strategies[J]. Pharmacol Ther，2017， 180：99-112.
[10] SOLOMON R，DAUERMAN H L. Contrast-induced acute kidney injury[J]. Circulation，2010，122（23）：2451-2455.
[11] OZKOK S，OZKOK A. Contrast-induced acute kidney injury：a review of practical points[J]. World J Nephrol，2017，6（3）：86-99.
[12] IMPROVING GLOBAL OUTCOMES KDIGO DIABETES WORK GROUP. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease[J]. Kidney Int，2020，98（4）：S1-S115.
[13] SHLIPAK M G，TUMMALAPALLI S L，BOULWARE L E，et al. The case for early identification and intervention of chronic kidney disease：conclusions from a kidney disease：improving global outcomes （KDIGO） controversies conference[J]. Kidney Int，2021，99（1）：34-47.
[14] LISS P，PERSSON P B，HANSELL P，et al. Renal failure in 57 925 patients undergoing coronary procedures using iso-osmolar or low-osmolar contrast media[J]. Kidney Int，2006，70（10）：1811-1817.
[15] WAIKAR S S，LIU K D，CHERTOW G M. Diagnosis，epidemiology and outcomes of acute kidney injury[J]. Clin J Am Soc Nephrol，2008，3（3）：844-861.
[16] 张亚梅，马玉凤，杨世诚，等. 复方丹参滴丸对经皮冠状动脉介入治疗术后对比剂肾病及患者预后的影响[J]. 中国药房，2021， 32（15）：5.
[17] YANG R，CHANG L，GUO B Y，et al. Compound danshen dripping pill pretreatment to prevent contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention[J]. Evid Based Complement Alternat Med，2014， 2014：256268.

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备注/Memo

备注/Memo:
基金项目 天津市卫生健康委员会天津市中医药管理局中医中西医结合科研课题（2021205）
作者简介 万瑜（1999-），女，硕士在读，研究方向：心血管疾病；通信作者：付乃宽，E-mail：cdrfnk@163.com。
更新日期/Last Update: 2024-09-20