本文選題：造影劑腎病 + 冠脈動脈造影術(shù)��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討保腎片對冠狀動脈造影術(shù)(coronary angiography,CAG)和(或)經(jīng)皮冠狀動脈介入治療術(shù)(percutaneous coronary intervention,PCI)后造影劑腎病(contrast-induced nephropathy,CIN)的預(yù)防和治療作用。方法:將擬行CAG或(和)PCI術(shù)的患者80例隨機(jī)分為兩組,①治療組:常規(guī)標(biāo)準(zhǔn)治療的基礎(chǔ)上加保腎片(40例);②對照組:常規(guī)標(biāo)準(zhǔn)治療(40例)。所有患者檢測術(shù)前24小時、術(shù)后24小時及72小時血肌酐(serum creatinine,Scr)、血胱抑素C(serum cystatin C,Cys-C)、尿 β-半乳糖苷酶(β-galactosidase,GAL)。結(jié)果:①術(shù)后24小時治療組血Cys-C較對照組降低,有統(tǒng)計學(xué)意義(P0.05);術(shù)后72小時治療組Scr、血Cys-C、尿GAL較對照組明顯降低,有統(tǒng)計學(xué)意義(P0.01),腎小球濾過率(estimated Glomerular Filtration,eGFR)治療組較對照組高,有統(tǒng)計學(xué)意義(P0.01)。②治療組術(shù)后72小時尿GAL較術(shù)前降低,有統(tǒng)計學(xué)意義(P0.05),Scr較術(shù)前明顯降低,eGFR較術(shù)前升高,有統(tǒng)計學(xué)意義(P0.01);術(shù)后24小時較術(shù)前無明顯差異(P0.05);③對照組血Cys-C術(shù)后24小時升高,有統(tǒng)計學(xué)意義(P0.05);術(shù)后72小時Scr、尿GAL、血Cys-C較術(shù)前明顯升高,eGFR較術(shù)前明顯降低,差異有統(tǒng)計學(xué)意義(P0.01)。④術(shù)后72小時共發(fā)生CIN 5例,全部為對照組,治療組發(fā)生率為0%;對照組發(fā)生率為12.5%,差異有統(tǒng)計學(xué)意義(P0.01)。結(jié)論:造影劑對腎功能有損害作用;保腎片能夠降低Scr、血Cys-C、尿GAL,可能對降低造影劑對腎功能的損害,改善腎功能有一定的作用;保腎片對CIN可能有一定的預(yù)防作用。
[Abstract]:Objective: to investigate the preventive and therapeutic effects of Baoshen tablet on contrast-induced nephropathy after coronary angiography (CAG) and / or percutaneous coronary intervention (PCI). Methods: 80 patients undergoing CAG or / or PCI were randomly divided into two groups: the control group (n = 40) and the control group (n = 40). Serum creatinine scr, cystatin serum cystatin Cys-Cn and urinary 尾 -galactosidase (尾 -galactosidase) were detected in all patients 24 hours before operation, 24 hours and 72 hours after operation. Results the blood Cys-C of the treatment group was significantly lower than that of the control group at 24 hours after operation (P 0.05), and that of the treatment group at 72 hours after operation was significantly lower than that of the control group (P 0.01), and the glomerular filtration rate was significantly higher in the treatment group than in the control group. In the treatment group, the urinary gal was significantly decreased at 72 hours after operation, and the level of creatinine (SCR) in the treatment group was significantly lower than that in the preoperative group, and the level of creatinine globulin (GFR) was significantly increased in the treatment group. There was no significant difference in serum Cys-C between 24 hours after operation and 24 hours after operation, which was statistically significant (P0.05), and at 72 hours after operation, the levels of serum Cys-C and Cys-C in the control group were significantly higher than those before operation, and the levels of Cys-C in the control group were significantly lower than those in the preoperative group at 72 hours after the operation, and the levels of Cys-C in the control group were significantly lower than those before the operation. There were significant differences in the incidence of cin in the control group (n = 5) and the control group (n = 12. 05) at 72 hours postoperatively. Conclusion: contrast agent can damage renal function, Baoshen tablet can reduce Scrs, blood Cys-Cand urinary Gall, it may have certain effect on reducing renal function damage and improving renal function of contrast agent, and Baoshen tablet may have certain preventive effect on cin.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5

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