Objective: To explore therapeutic effect of in-hospital intravenous alprostadil injection on patients with acute myocardial infarction (AMI) complicated diabetic nephropathy (DN) undergoing percutaneous coronary intervention (PCI), and evaluate their long-term prognosis.Methods: A total of 80 AMI + DN patients undergoing PCI were selected from our hospital.They were randomly divided into alprostadil group (n=40) and routine treatment group (n=40).Renal function after PCI, cardiac function during hospitalization, serum creatinine (Scr) level on 72h after PCI and incidence of major adverse cardiovascular events (MACE) within one-year follow-up were compared between two groups.Results: Compared with routine treatment group on 72h after PCI, there was significant reduction in Scr level [(126.92±35.28) μmol/L vs.(104.32±22.91) μmol/L], and significant rise in estimated glomerular filtration rate [eGFR, (55.23±31.48) ml·min-1·1.73m-2 vs.(62.14±36.23) ml·min-1·1.73m-2] in alprostadil group, P<0.05 both.Postoperative one-year follow-up indicated that there were no significant difference in incidence rate of MACE and percentage of kidney replacement therapy between two groups, P>0.05 all.Conclusion: Intravenous alprostadil injection based on routine treatment possesses significant therapeutic effect on renal function in AMI + DN patients after PCI, and it's safe%目的:探讨急性心肌梗死(AMI)合并糖尿病肾病行经皮冠状介入治疗(PCI)的患者住院期间静脉推注前列地尔注射液的临床疗效及远期预后评价.方法:选择我院急性心肌梗死合并糖尿病肾病行PCI治疗的患者80例,随机分成前列地尔组(40例)和常规治疗组(40例),比较两组患者术后对比剂肾病发生率、住院期间心功能、术后72h血肌酐(Scr)水平变化以及术后1年内随访主要不良心血管事件(MACE)情况.结果:术后72h,与常规治疗组比较,前列地尔组Scr水平[(126.92±35.28) μmol/L比(104.32±22.91) μmol/L]明显降低,估测的肾小球滤过率(eGFR)水平[(55.23±31.48) ml·min-1·1.73m-2比(62.14±36.23) ml·min-1·1.73m-2]明显提高(P均<0.05);术后1年随访结果显示两组MACE和肾脏替代治疗差异无统计学意义(P均>0.05).结论:常规治疗联合前列地尔注射液对心肌梗死合并糖尿病肾病患者介入治疗术后的肾功能改善有显著作用,并且是安全的.
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