Objective: To investigate the preventive effect of alprostadil (prostaglandin E1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71 %) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg•h) at 6 hours prior and 12 hours after PCI,n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 10μg in 100ml normal saline twice a day at 1 day prior PCI and the 3rd day after PCI,n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the CIN occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) μmol/L was lower than Control group (99.43 ± 22.77) μmol/L,P<0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ± 20.58) ml/min was higher than Control group (57.09 ± 22.31) ml/min,P<0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients),P<0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.%目的：探讨前列地尔（前列腺素E1）联合水化治疗对老年冠心病患者行经皮冠状动脉介入治疗（PCI）术后对比剂肾病（CIN）的预防作用。方法：选择2011-03至2014-03我院收治的175例年龄＞70岁冠心病行PCI 术患者纳入本研究，男122例（9.71%），平均年龄（74.7±3.9）岁，随机数字法分为两组：对照组（n=84）：在常规治疗基础上，术前6 h和术后12 h给予1 ml/（kg·h)生理盐水静脉滴注水化治疗；前列地尔联合水化组（n=91）：在常规治疗、水化治疗基础上，于术前1天和术后第3天静脉滴注前列地尔10μg，溶于100 ml生理盐水，2次/d。两组患者于PCI术前及术后连续3天分别测定血清肌酐水平（SCr）并计算内生肌酐清除率（Ccr），观察两组CIN的发生率。结果：Scr水平：术后第3天前列地尔联合水化组与对照组同期比较降低[（92.08±21.65） mmol/L vs （99.43±22.77）μmol/L]，差异有统计学意义（P<0.05）。Ccr：术后第3天前列地尔联合水化治疗组与对照组同期比较升高[（63.78±20.58） ml/min vs （57.09±22.31） ml/min]，差异有统计学意义（P<0.05）。PCI术后CIN的发生率：前列地尔联合水化组3.3%（3例）较对照组13.1%（11例）降低，差异有统计学意义（P<0.05）。结论：对于老年冠心病行PCI者，前列地尔联合水化治疗可以明显改善患者术后肾功能，降低CIN的发生。
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