OBJECTIVE:To probe into the efficacy of alprostadil combined with intravenous hydration in prevention of contrast-induced nephropathy ( CIN ) after percutaneous coronary intervention ( PCI ) in patients with coronary heart disease and type 2 diabetes mellitus. METHODS:120 patients with coronary heart disease and type 2 diabetes mellitus undergoing PCI in Leping Oriental Hospital of Jiangxi from Jun. 2014 to Nov. 2016 were extracted to be divided into observation group and control group via the random number table, with 60 cases in each. The control group was given intravenous hydration, while the observation group additionally received alprostadil based on the control group, the treatment course last for 4d. The renal function at different time points before and after surgery, and incidence of CIN while in hospital of two groups were compared. RESULTS:At different time points after surgery, the blood urea nitrogen (BUN), serum creatinine(SCR) and β2 microglobulin(β2-MG) levels of two groups increased significantly compared with before surgery, and the ascending range of control group was higher than the observation group. Level of 72 h BUN in observation group after surgery, Scr at different time points, andβ2-MG level of 48, 72 h after surgery in observation group were significantly lower than those in the control group. The glomerular filtration rate( GFR) of observation group at different time points were significantly higher than those of the control group, with statistically significant difference (P<0. 05). The incidence of CIN of observation group was 6. 67％(4/60), significantly lower than that of the control group [23. 33％(14/60)], with statistically significant difference(P<0. 05). CONCLUSIONS: Alprostadil combined with intravenous hydration in prevention of CIN after PCI in patients with coronary heart disease and type 2 diabetes mellitus can effectively reduce the incidence of CIN, protect the renal function of patients.%目的:探讨前列地尔联合静脉水化治疗预防冠心病合并2型糖尿病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后早期对比剂肾病(contrast-induced nephropathy,CIN)的效果.方法:选取于2014年6月—2016年11月乐平东方医院拟行PCI的冠心病合并2型糖尿病患者120例,以随机数字表法分为观察组和对照组,每组60例.对照组患者采用静脉水化治疗,观察组患者在对照组基础上联合应用前列地尔,两组患者均持续治疗4d.比较两组患者术前、术后不同时间点的肾功能及住院期间CIN发生情况.结果:术后不同时间点,两组患者的尿素氮(BUN)、肌酐(Scr)及β2微球蛋白(β2-MG)水平均较术前明显升高,且对照组患者升高幅度明显大于观察组;观察组患者术后72 h的BUN、术后各时间点的Scr,以及术后48、72 h的β2-MG水平均明显低于对照组;观察组患者术后各时间点的肾小球滤过率(GFR)均明显高于对照组,差异均有统计学意义(P<0.05).观察组患者CIN发生率为6.67％(4/60),明显低于对照组的23.33％(14/60),差异有统计学意义(P<0.05).结论:前列地尔联合静脉水化治疗用于行PCI术的冠心病合并2型糖尿病患者,可有效降低CIN发生率,保护患者肾功能.
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