[1]陈存芳)△,江珊).重组人B型钠尿肽联合水化对慢性充血性心力衰竭患者造影剂肾病的防治作用[J].郑州大学学报(医学版),2014,(06):852.
 CHEN Cunfang,JIANG Shan.Prevention effects of recombinant human Btype natriuretic peptide and hydration against contrast induced nephropathy in patients with chronic congestive heart failure[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2014,(06):852.
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重组人B型钠尿肽联合水化对慢性充血性心力衰竭患者造影剂肾病的防治作用
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2014年06期
页码:
852
栏目:
应用研究
出版日期:
2014-11-20

文章信息/Info

Title:
Prevention effects of recombinant human Btype natriuretic peptide and hydration against contrast induced nephropathy in patients with chronic congestive heart failure
作者:
陈存芳1)△江珊2)
1)锦州市中心医院CCU病房 锦州 1210002)锦州市中心医院心内科 锦州 121000
Author(s):
CHEN Cunfang1) JIANG Shan2)
1)Department of CCU,Jinzhou Central Hospital,Jinzhou 1210002)Department of Cardiology,Jinzhou Central Hospital,Jinzhou 121000
关键词:
造影剂肾病B型钠尿肽慢性充血性心力衰竭经皮冠状动脉介入治疗
Keywords:
contrast induced nephropathyBtype natriuretic peptidechronic congestive heart failurepercutaneous coronary intervention
分类号:
R541.1
摘要:
目的:探讨重组人B型钠尿肽(rhBNP)对合并慢性充血性心力衰竭(CHF)患者造影剂肾病(CIN)的防治效果。方法:选择行择期经皮冠状动脉介入治疗(PCI)的合并CHF的不稳定性心绞痛患者168例,分为rhBNP组(82例)和对照组(86例),两组患者均接受常规药物及水化治疗,rhBNP组在此基础上于PCI术前12 h开始应用rhBNP至术后24 h。测定PCI术前、术后24和48 h血肌酐(SCr)、估计的肾小球滤过率(eGFR),统计CIN发生率;测定PCI术前、术后1和7 d血浆B型钠尿肽(BNP)水平、左室射血分数(LVEF)、左室舒张末内径(LVEDD)。结果:rhBNP组患者术后SCr较术前逐渐升高但低于对照组(F组间=9.399,F时间=24.566,F交互=26.008,P<0.01),eGFR较术前逐渐降低但均高于对照组(F组间=12.880,F时间=33.263,F交互=25.307,P<0.01),rhBNP组CIN发生率低于对照组(3.7% vs 16.3%,χ2=7.351,P=0.007)。rhBNP组术后血浆BNP水平较术前降低,对照组则较术前升高(F组间=9.148,F时间=4.745,F交互=216.413,P<0.05)。rhBNP组术后LVEF逐渐升高,LVEDD逐渐缩小;对照组术后1天LVEF较术前明显降低,LVEDD明显增大,术后7 d恢复至术前水平(LVEF:F组间=7.497,F时间=3.740,F交互=118.041,P<0.05;LVEDD:F组间=19.116,F时间=5.782,F交互=106.593,P<0.05)。结论:rhBNP联合水化治疗可改善CHF患者心功能,减少CIN的发生。
Abstract:
Aim: To investigate the prevention effects of recombinant human Btype natriuretic peptide(rhBNP) against contrast induced nephropathy(CIN) in patients with chronic congestive heart failure(CHF). Methods: A total of 168 unstable angina patients with CHF and percutaneous coronary intervention(PCI), were divided into treatment group(82 cases) and control group(86 cases).The two groups were treated with routine drugs and hydration, and the treatment group was continuously given rhBNP from 12 h before PCI to 24 h after PCI. Serum creatinine(SCr), estimated glomerular filtration rate(eGFR) were measured before PCI and 24 h, 48 h after PCI, and the incidence of CIN were analyzed. Plasma level of BNP, left ventricular ejection fraction(LVEF), left ventricular enddiastolic dimension(LVEDD) were measured before PCI and 1 d, 7 d after PCI. Results: SCr increased gradually after PCI in treatment group, but were still lower than that of the control group(Fgroup=9.399, Ftime=24.566,Finteraction=26.008,P<0.01); eGFR decreased gradually after PCI, but still were higher than that of the control group(Fgroup=12.880, Ftime=33.263,Finteraction=25.307,P<0.01). CIN incidence in treatment group was 3.7%,lower than that of the control group 16.3%(χ2=7.351,P=0.007). After PCI, the plasma BNP level was reduced in treatment group, but increased obviously in control group compared with before PCI(Fgroup=9.148, Ftime=4.745,Finteraction=216.413,P<0.05); LVEF increased and LVEDD was reduced gradually in treatment group after PCI, while LVEF decreased and LVEDD increased in control group 1 d after PCI compared with those before PCI, and restored to the normal level 7 day after PCI(LVEF:Fgroup=7.497,Ftime=3.740,Finteraction=118.041,P<0.05;LVEDD:Fgroup=19.116, Ftime=5.782,Finteraction=106.593,P<0.05). Conclusion: rhBNP combined with hydration can not only improve cardiac function of patients with CHF, but also reduce the CIN incidence.

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备注/Memo

备注/Memo:
△男,1981年2月生,硕士,主治医师,研究方向:冠心病的介入治疗,Email:sdccfjb@126.com
更新日期/Last Update: 2014-11-26