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目的:探讨金水宝胶囊联合水化治疗对预防肾功能不全患者的造影剂肾病的价值。方法:将2012年7月至2014年6月普宁市人民医院收治的拟行冠脉造影的120例肾功能不全患者随机分为3组即联合治疗组、单纯水化组和对照组。每组40例。联合治疗组接受金水宝胶囊口服治疗+水化治疗+常规治疗;单纯水化组接受水化治疗+常规治疗;对照组仅接受常规治疗。比较3组患者术前,术后1、3、7 d血肌酐(Scr)及血尿素氮(BUN)的动态变化。结果:与术前比较,对照组和单纯水化组术后1 d Scr水平显著升高,术后3 d达高峰,术后7 d回落至术前水平(P<0.05)。联合治疗组Scr水平未出现术后先增加后回落的趋势,术后水平与术前相当(P>0.05)。与术前比较,对照组和单纯水化组BUN水平持续走高(P<0.05)。联合治疗组术后各时相点BUN水平与术前相当(P>0.05)。联合治疗组、单纯水化组、对照组患者造影剂肾病发生率分别为2.5%、5.0%、20.0%,3组比较,差异有统计学意义(P<0.05)。结论:肾功能不全患者行冠脉造影时,同时给予金水宝胶囊联合水化治疗较单纯水化治疗更能预防造影剂肾病。
Objective: To investigate the value of Jinshuibao capsule combined with hydration therapy in the prevention of contrast-induced nephropathy in patients with renal insufficiency. Methods: A total of 120 patients with renal insufficiency who underwent coronary angiography at Puning People’s Hospital from July 2012 to June 2014 were randomly divided into three groups: combination therapy group, simple hydration group and control group. 40 cases in each group. The combined treatment group received oral Jinshuibao + hydration therapy + conventional therapy; hydration alone group received routine hydration therapy; the control group received only routine treatment. The dynamic changes of serum creatinine (Scr) and blood urea nitrogen (BUN) were compared between the three groups before and after operation. Results: The levels of Scr in control group and simple hydration group were significantly increased at 1 d after operation and peaked at 3 d after operation, and returned to the preoperative level on the 7 d after operation (P <0.05). The Scr level in the combined treatment group did not show a trend of first increasing and then decreasing after operation, and the postoperative level was similar to that before operation (P> 0.05). Compared with preoperative, BUN levels in control group and simple hydration group continued to increase (P <0.05). The BUN level in the combined treatment group at each time point was similar to that before operation (P> 0.05). The incidence of contrast nephropathy was 2.5%, 5.0% and 20.0% respectively in the combined treatment group, pure hydration group and control group. The difference was statistically significant (P <0.05). Conclusions: When coronary angiography is performed in patients with renal insufficiency, simultaneous administration of Jinshuibao capsule combined with hydration therapy can prevent contrast-induced nephropathy more than simple hydration therapy.