Influence Of PGE₁on Contrast Media-induced Renal Dysfunction In Patients Undergoing Coronary Artery Interventional Therapy

Objective:To study the protective effects of different doses of prostaglandin E1on contrast media-induced renal dysfunction in patients undergoing coronary artery interventional therapy.Methods:114cases of coronary artery interventional therapy patients were chose at the Fist Affiliated Hospital of Kunming University from October2010to December2011as research subjects, which is randomly divided into group A (n=39), group B (n=38)and group C (n=28). Group A received routine treatment, groups B, C received different doses of PGE1(lOug,20ug)30minutes before operation, Oh,12h and24h after operation, each20ml,40ml saline diluted intravenous continuous infusion with lOng/kg/min,20ng/kg/min. All patients'serum creatinine (Scr), blood urea nitrogen (BUN), serum cystatin (Cys C) and blood β2-microglobulin (β2-MG) were measured before operation,2h,24h and48h after operation. Evaluate Glomerular Filtration Rate (eGFR) was calculated according to the modified MDRD creatinine of the Chinese population. The incidence of CIN was analyzed.Results:The baseline data and procedure features were not significantly different statistically among the three groups (P>0.05). There was no significant difference in BUN compared among and within the three groups (P>0.05). In Group A after operation2h,24h,48h,Scr was higher compared to baseline (P<0.05); In Group C. Scr was lower than group B before and after operation2h (P<0.05). and was lower than group A after operation24h (P<0.05), and was lower than group A.B after operation48h (P<0.05). In group A after operation2h,24h.48h. eGFR was lower compared to baseline (P<0.05); In Group C, eGFR was higher than group B before operation and after operation2h (P<0.05), and was higher than group A after operation24h(P<0.05). and was higher than group A. B after operation48h (p<0.05); In group C after operation24h Cys C and2h β2-MG were lower compared to the same point in time A. B group (P<0.05),2h (32-MG was lower compared to baseline (P<0.05).Conclusion:During perioperative period, contrast medium can induce renal dysfunction. Coronary artery interventional therapy of patients with perioperation period of48hours, pretreatment with prostaglandin E180ug (20ng/kg/min) can reduce acute renal function damage by the contrast medium, improve renal function and prevent contrast-induced nephropathy. Age>75years of age is a risk factor for CIN.