Preventive Effect of Alprostadil Combining Hydration Therapy on Contrast-induced Nephropathy After Percutaneous Coronary Intervention in Elder Patients / 中国循环杂志

ABSTRACT

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.