王妍　邢艳秋　刘春

【摘要】 目的：探讨外源性磷酸肌酸对冠状动脉介入治疗患者肾功能的影响。方法：选择2015年10月-2016年7月山东大学齐鲁医院住院接受冠状动脉介入治疗的患者70例，随机分为试验组和对照组两组，每组各35例。试验组于术前给予磷酸肌酸静脉滴注，对照组常规水化治疗，均于术前、术后2、4、8、24 h抽血检测肌酐（Scr），计算肾小球滤过率（GFR）和对比剂肾病（CIN）发生率。结果：术前两组肌酐、尿素氮、肾小球滤过率比较差异无统计学意义（P>0.05），对照组肌酐术后2、24 h与术前相比差异有统计学意义（P<0.05），试验组与对照组尿素氮术后2、4、8、24 h与术前比较差异有统计学意义（P<0.05）。对照组肾小球率过滤术后2 h与术前比较差异有统计学意义（P<0.05），对照组CIN发生率为5.71%。结论：介入治疗术前应用磷酸肌酸对患者肾功能有保护作用。

【关键词】 磷酸肌酸； 对比剂； 冠状动脉介入治疗； 肾功能

Protective Effects of Phosphocreatine on Kidney in Patients Undergoing Percutaneous Coronary Intervention/WANG Yan，XING Yan-qiu，LIU Chun.//Medical Innovation of China，2017，14（16）：001-004

【Abstract】 Objective：To investigate the effect of exogenous phosphocreatine on renal function in patients undergoing coronary intervention.Method：A total of 70 cases who received percutaneous coronary intervention in Qilu Hospital of Shandong University were selected from October 2015 to July 2016 and were randomly divided into experimental group and control group，35 cases in each group.The experimental group was given intravenous infusion of phosphocreatine before surgery.The control group was given conventional hydration therapy.Serum creatinine was monitored before angiography，after angiography 2，4，8 and 24 h.Glomerular filtration rate and the incidence of contrast induced nephropathy of two groups were estimated.Result：There was no statistical difference in Scr、BUN and GFR of two groups before operation（P>0.05）.There were statistically significant differences in creatinine level at 2 and 24 hours compared with preoperative in the control group（P<0.05）.The levels of urea nitrogen in the two groups of 2，4，8，24 hours were statistically different from those before operation（P<0.05）.The glomerular filtration rate was significantly different from that of the control group 2 hours after operation（P<0.05）.The incidence of contrast nephropathy in the control group was 5.71%.Conclusion：The use of phosphocreatin before percutaneous coronary intervention has a protective effect on renal function.

【Key words】 Phosphocreatine； Contrast agent； Coronary interventional therapy； Renal function

First-authors address：School of Medicine and Life Sciences，University of Jinan &Shandong Academy of Medical Sciences，Jinan 250062，China；Institute of Basic Medicine，Shandong Academy of Medical Sciences，Jinan 250062，China

doi：10.3969/j.issn.1674-4985.2017.16.001

經皮冠状动脉介入治疗（PCI）是冠心病治疗的有效手段，尤其是急性冠脉综合征的介入治疗，可以最有效的缓解症状并改善长期预后，但PCI手术中的心肌缺血再灌注损伤及造影剂肾损伤均是常见的严重并发症，增加了患者的死亡率和再住院率[1-3]。磷酸肌酸作为细胞能量储存的主要方式，能快速的为缺血缺氧的损伤心肌提供能量，有研究证实PCI术前应用磷酸肌酸对心脏有保护作用。但磷酸肌酸对肾脏功能是否也有保护作用尚未见报道[4]。因此，本研究旨在探讨冠状动脉介入术前应用外源性磷酸肌酸对患者肾功能的影响。

1 资料与方法

1.1 一般资料 选择2015年10月-2016年7月山东大学齐鲁医院住院接受冠状动脉介入治疗的患者70例，诊断符合1979年WHO冠心病诊断标准，其中男44例，女26例，平均年龄（62.31±8.13）岁。随机分为试验组与对照组两组，每组各35例。进入试验前向所有受试者或其监护人告知本研究目的、方法并签署知情同意书。排……