尼可地尔联合冠状动脉心脏介入治疗冠心病合并肾功能不全的疗效及对NGAL、Cys-C的影响

摘要 目的：探析冠心病（CHD）合并肾功能不全（RI）应用冠状动脉心脏介入治疗（PCI）联合尼可地尔的临床疗效及对胱抑素C（Cys-C）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）影响。方法：选择本院2019年6月~2021年6月就诊的86例CHD合并RI患者，随机数字表法分为两组各43例。 两组均实施PCI治疗，对照组实施常规静脉水化处理，观察组联合尼可地尔治疗。对比两组PCI治疗前后24 h肾功能指标（Cys-C、NGAL）、血清炎性因子指标（高敏C反应蛋白 (hs-CRP)、白细胞介素 6 (IL-6)）、心肌损伤指标（心肌肌钙蛋白I（cTnI）及肌酸激酶同工酶（CK-MB））、并发症发生率。结果：观察组CIN发生率（2.33%）、MACE率（2.33%）均明显低于对照组（16.28%、13.95%），有统计学差异（P<0.05）。两组PCI治疗前Cys-C、NGAL、hs-CRP、IL-6、cTnI、CK- MB无统计学差异（P<0.05）。治疗后观察组Cys-C、NGAL、hs-CRP、IL-6升高幅度、组cTnI、CK- MB明显低于对照组（P<0.05）。结论：PCI 联合尼可地尔应用于CHD合并RI临床治疗效果显著，可有效改善患者肾功能，降低炎症反应、心肌损伤，预防CIN发生。

Effect of Nicorandil Combined with Coronary Intervention on Coronary Heart Disease Combined with Renal Insufficiency and its Influence on NGAL and Cys-C

ABSTRACT Objective: To explore the clinical effects of coronary heart disease (CHD) combined with renal insufficiency (RI) using coronary heart intervention (PCI) combined with nicorandil and its effects on cystatin C(Cys-C) and neutrophil gelatinase-associated lipocalin (NGAL). Methods: A total of 86 cases of CHD combined with RI who visited our hospital from June 2019 to June 2021 were selected and randomly divided into two groups with 43 cases in each group according to random number table. Both groups were treated with PCI, while the control group was treated with conventional intravenous hydration and the observation group was treated with nicorandil. The renal function indexes (Cys-C and NGAL) at 24 h, serum inflammatory factor indexes (high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6)), myocardial injury indexes (cardiac troponin I(cTnI) and creatine kinase isoenzyme (CK-MB)) and the incidence of complications before and after PCI were compared between the two groups. Results: The incidence of CIN (2.33%) and MACE(2.33%) in the observation group were significantly lower than those in the control group(16.28% and 13.95%), with statistical difference(P<0.05). There was no statistical difference in Cys-C, NGAL, hs-CRP, IL-6, cTnI, and CK- MB between the two groups before PCI(P<0.05). After treatment, the increases in Cys-C, NGAL, hs-CRP, and IL-6 as well as the cTnI and CK- MB in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: PCI combined with nicorandil has significant effect in the clinical treatment of CHD combined with RI, which can effectively improve renal function, reduce inflammation, myocardial damage and prevent the occurrence of CIN.