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OBJECTIVE：To observe the effects of Compound danshen drip ping pills on the prevention of contrast-induced nephropathy（CIN）after percutaneous coronary intervention （PCI）and its influence on clinical prognosis. METHODS ：From Jan. to Jun. 2020，240 patients with coronary heart disease receiving PCI in Tianjin Chest Hospital were randomly divided into control group（120 cases）and Danshen dripping pills group （120 cases）according to random number table. The patients in both groups were injected with Lippaclitanol injection 1-5 mL slowly through radial or femoral artery sheath ，and intravenous hydration was performed before and after PCI ；Danshen dripping pills group was additionally given Compound danshen dripping pills 270 mg orally for a long term ，three times a day ，three days before and after PCI ，on the basis of the control group. The levels of renal function indexes [serum creatinine （Scr），blood urea nitrogen （BUN），cystatin C （Cys-C），creatinine clearance rate （Ccr）]， inflammatory reaction indexes [high sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）] and oxidative stress index [malondialdehyde （MDA）] were observed in 2 groups before and 72 hours after PCI. The occurrence of CIN in 2 groups was recorded 3 days after PCI therapy ；the occurrence of major cardiovascular adverse events was also observed during 1-year follow-up period. RESULTS ：Before treatment ，there was no significant difference in serum renal function indexes ，inflammatory reaction indexes and oxidative stress index between 2 groups（P＞0.05）. Seventy-two hours after PCI ，serum levels of Scr ，BUN， Cys-C，hs-CRP，IL-6 and MDA were increased significantly in 2 groups than before treatment ，while the Ccr were decreased significantly；those indexes of Danshen dripping pills group were significantly better than those of control group （P＜ 0.05）. The incidence of CIN in Danshen dripping pills group was 4.2％ after treatment ， and total incidence of major cardiovascular adverse events was 13.3％ during follow-up period，which were sign ificantly lower than 13.3％ and 27.5％ of control group （P＜0.05）. CONCLUSIONS ：Compound danshen dripping pills may have a certain effect on the prevention of CIN in coronary heart disease patients after PCI ，and can reduce the incidence of major cardiovascular adverse events.
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Objective To investigate the relationship of low level of high-density lipoprotein cholesterol to contrast induced-acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods A total of 1500 consecutive patients,who underwent PCI from January 2009 to May 2011,were enrolled in this study.There was no limit on age or sex,and all patients were self-identified as Han ethnic group.Patients were excluded from this study,however,if they had a history of malignant tumor,urinary tract infection,nephrectomy operation,chronic peritoneal or hemodialysis,or if they had been exposed to contrast media within the past 14 days.CI-AKI was defined as an absolute increase in serum creatinine ≥44.2 μmol/L or a relative ≥25％ increase in serum creatinine within 72 hours after procedure.Low level of HDL-C was defined as ＜ 1.04 mmol/L.Monofactorial and multivariate analysis was performed to identify risk factors for CI-AKI and low level of HDL-C in these patients.Results Among the 1500 patients with coronary heart disease,CI-AKI occurred in 246 patients after PCI and the overall incidence of CI-AKI was 16.4％.The patients with low level of HDL-C had a higher incidence of CI-AKI than those without it (21.5％ vs.13.3％ in total,P ＜0.01),no matter that they had suffered from chronic kidney disease (39.8％ vs.26.5％,P ＜ 0.05) or not (17.7％ vs.9.7％,P ＜ 0.01).By multivariate analysis,low level of HDL-C was identified as an independent risk factor for CI-AKI and smoke,great BMI as well as anemia were considered as prediction factors for low level of HDL-C.Conclusion The patients with low level of HDL-C have a higher incidence of CI-AKI after PCI.Low level of HDL-C is one of risk factors for CI-AKI after PCI in patients either with chronic kidney disease or not.Great BMI,smoking as well as anemia are independent predictors for low HDL-C level in these patients.
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Objective To study the role of prostaglandin E1 in prevention of contrast-induced ne-phropathy (CIN)in elderly CHD patients undergoing PCI .Methods Three hundred elderly CHD patients who were going to undergo PCI in Tianjin Chest Hospital were divided into prostaglandin E1 treatment group (n=150) and conventional treatment group (n=150) .Patients in prostaglan-din E1 treatment group were treated with 20 μg prostaglandin E1 plus hydration therapy and those in conventional treatment group received simple hydration therapy .T heir serum levels of creatinine ,urea ,β2-microglobulin ,24 h proteinuria ,CRP ,IL-6 ,TNF-α,GPX ,SOD ,and creatinine clearance rate were measured before and 3 d after PCI .The incidence of CIN in two groups was analyzed .The hypotension events in prostaglandin E1 treatment group were recorded .Results The serum levels of CRP ,SOD ,GPX ,24 h proteinuria and the incidence of CIN were significantly lower while the creatinine clearance rate was significantly higher in prostaglandin E 1 treatment group than in conventional treatment group after PCI (P<0 .05) .The serum levels of CRP ,IL-6 , SOD ,GPX and 24 h proteinuria were significantly higher in two groups after PCI than before PCI (P<0 .05) .Conclusion Prostaglandin E1 can protect the renal function in CHD patients under-going PCI and play a certain role in preventing CIN .
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Objective To investigate the preventive effect of N-acetylcysteine (NAC) on contrast-induced nephropa-thy (CIN) in patients undergoing elective percutaneous coronary intervention (PCI). Methods A total of 521 patients under-went PCI in Tianjin were randomly divided into conventional treatment group (n=261) and NAC treatment group (n=260). NAC treatment group was given oral NAC (600 mg twice daily) for 48 h and 72 h before PCI plug hydration therapy, and the conventional treatment group was given only hydration therapy. The serum levels of creatinine(Scr), urea nitrogen(BUN), creatinine clearance rate (Ccr), C-reactive protein (CRP),β2-microglobulin(β2-MG), tumor necrosis factor-α(TNF-α), inter-leukin-6 (IL-6), superoxide dismutase (SOD), glutathione peroxidase (GPX) and incidence of CIN were detected at admission and 72 h after the procedure. Results (1) There was no significant difference in the incidence of CIN between NAC treat-ment group (6.2%) and conventional treatment group (3.8%,χ2=1.48, P>0.05). (2) There were no significant differences in se-rum levels of Scr, BUN, Ccr, CRP,β2-MG, TNF-α, IL-6, SOD and GPX before PCI ( P>0.05). (3) The serum levels of CRP, SOD and GPX were significantly higher 72 h after the procedure in two groups ( P＜0.05). There were significantly lower se-rum levels in CRP, SOD and GPX in NAC treatment group than those of conventional treatment group ( P＜0.05). There were no significant differences in serum levels of Scr, BUN,β2-MG and Ccr between NAC treatment group and conventional treat-ment group ( P >0.05). Conclusion N-acetylcysteine may have no beneficial effect on the prevention of CIN after PCI.