Abstract:

Objective　To evaluate the safety and efficacy of nicorandil combined with hydration therapy in the prevention of contrast-induced nephropathy (CIN) in coronary heart disease patients after percutaneous coronary intervention (PCI). Methods　Two hundred patients with coronary heart disease treated in Department of Cardiology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2022 to April 2023 were randomly divided into a control group and a nicorandil group, with 100 cases in each group. There were 59 males and 41 females in the control group; they were (64.33±10.24) years old. There were 55 males and 45 females in the nicorandil group; they were (65.11±10.21) years old. The control group were treated only with hydration, while the nicorandil group with nicorandil and hydration. Serum creatinine (Scr) and cystatin C (CysC) were tested in all the enrolled patients before and after the operation. The estimated glomerular filter rate (eGFR) was calculated. The changes in the serum levels of Scr and CysC and eGFR, as well as the incidences of CIN and serious adverse cardiovascular events, were observed in both groups. t test, χ² test, and Fisher exact probability test were used for the statistical comparisons. Results　There were 17 cases (8.5%) of CIN among the 200 patients, including 13 cases (13.0%) in the control group and 4 cases (4.0%) in the nicorandil group. There was a statistical difference in the incidence of CIN between the two groups (P<0.05). Compared with the control group, the nicorandil group had low lower serum levels of Scr and CysC and higher eGFR after the operation, with statistical differences (all P<0.05). No serious adverse cardiovascular events occurred in the patients. Conclusion　Nicorandil combined with hydration can reduce the incidence of CIN after PCI, with no serious cardiovascular adverse events.

Key words:

Coronary heart disease, Contrast-induced nephropathy, Nicorandil, Hydration therapy, Percutaneous coronary intervention,  , Prevention

摘要：

目的　探讨在水化治疗基础上联合应用尼可地尔对冠心病患者经皮冠状动脉介入（percutaneous coronary intervention，PCI）术后对比剂肾病（contrast-induced nephropathy，CIN）的发生率，并观察其临床效果。方法　选取2022年1月至2023年4月在徐州医科大学附属徐州市立医院心血管内科行PCI治疗的200例冠心病患者，分为对照组和尼可地尔组，各100例。对照组中，男59例，女41例，年龄（64.33±10.24）岁，仅使用水化方案；尼可地尔组中，男55例，女45例，年龄（65.11±10.21）岁，在水化治疗的基础上加用尼可地尔预防CIN的发生。所有入选患者分别于术前、术后行血清肌酐（Scr）、血清胱抑素C（CysC）等相关检查，计算估测肾小球滤过率（eGFR）。观察两组患者血清Scr、CysC、eGFR变化及CIN发生率、严重心血管不良事件的发生情况。采用t、χ²检验或Fisher确切概率进行统计分析。结果　200例患者中，有17例（8.5%）发生CIN，其中对照组13例（13.0%，13/100），尼可地尔组4例（4.0%，4/100），两组CIN的发生率差异有统计学意义（P<0.05）。治疗后，尼可地尔组术后血清Scr、CysC低于对照组，eGFR高于对照组，差异均有统计学意义（均P<0.05）。所有患者均未出现严重的心血管不良事件。结论　在水化治疗的基础上，联合应用尼可地尔可降低PCI术后CIN的发生率，且无严重心血管不良事件发生。

关键词:

冠心病, 对比剂肾病, 尼可地尔, 水化, 经皮冠状动脉介入, 预防