前列腺素E1联合水化在PCI中的应用及对血肌酐和炎症反应的影响

摘要

Objective To study the application of prostaglandin-E1 (PG-E1) combined with hydration in percutaneous coronary intervention (PCI) and its influence on serum creatinine (SCr) and inflammatory reactions. Methods The patients with coronary heart disease (CHD, n=68) undergone PCI were chosen from Jiangbei Area of Zhongda Hospital of Southeast University from Aug. 2015 to June 2017, and divided, according to treatment status, into observation group and control group (each n=34). The control group (male=19 and female 15) were given hydration therapy, and observation group (male=18 and female 16) was given PG-E1 combined with hydration therapy. Results The levels of brachial artery flow-mediated dilation (FMD) and nitric oxide (NO) were significantly higher in observation group than those in control group after treatment (P<0.05). The levels of endothelin (ET) and high-sensitivity C-reactive protein (hs-CRP) were significantly lower in observation group than those in control group after treatment (P<0.05). The incidence of angina pectoris, heart failure, major adverse cardiovascular events (MACE) and in-stent restenosis were all significantly lower in observation group than those in control group after treatment (P<0.05). The incidence of acute myocardial infarction (AMI) and sudden cardiac death had no significant difference between 2 groups (P>0.05). The value of SCr decreased significantly, and value of endogenous creatinine clearance rate (Ccr) increased significantly in observation group compared with control group after PCI (P<0.05). Conclusion The therapy of PG-E1 combined with hydration can reduce inflammatory reactions, SCr level and incidence of MACE in CHD patients undergone PCI.%目的 研究前列腺素E1联合水化在经皮冠状动脉介入(PCI)术中的应用及对血肌酐和炎症反应的影响.方法 选择2015年8月~2017年6月于东南大学附属中大医院江北院区(南京市大厂医院)行PCI治疗的冠状动脉粥样硬化性心脏病(冠心病)患者68例,根据治疗情况分为观察组及对照组,每组各34例,对照组中男性19例,女性15例,采用水化法治疗;观察组中男性18例,女性16例,在对照组基础上联合前列腺素E1治疗.结果 治疗后观察组肱动脉血流介导性舒张功能(FMD)、一氧化氮(NO)水平显著高于对照组,差异有统计学意义(P<0.05),观察组血清内皮素(ET-1)、高敏C反应蛋白(hs-CRP)水平显著低于对照组,差异有统计学意义(P<0.05);治疗后观察组患者发生心绞痛、心力衰竭、主要心血管事件、支架内再狭窄率均明显低于对照组(P<0.05),观察组急性心肌梗死、心源性猝死发生率较对照组无明显差异(P>0.05);观察组PCI术后血清内生肌酐(Scr)值较对照组明显降低,且内生肌酐清除率(Ccr)值较对照组明显上升,差异有统计学意义(P<0.05).结论 前列腺素E1联合水化治疗行PCI术患者,可显著减少炎症反应,降低血清肌酐水平,显著降低心血管事件发生率.