The Study Of Alprostadil In Prevention Of Contrast Induced Nephropathy In Diabetic Patients After Percutaneous Coronary Intervention

Objective:To study the effect of Alprostadil Injection on contrast media-induced renal dysfunction in coronary heart disease combined with diabetic patients undergoing Coronary Artery Intervention Therapy.Methods:127cases of coronary heart disease combined with diabetic patients were chose at the First Affiliated Hospital of Kunming Medical University from march2013to march2014as research subjects, which had the percutaneous coronary artery stent implantation, coronary angiography showed that at least one vessel stenosis in50%and above. The patients were randomly divided into group A (n=63). group B (n=64). Group A:control group:conventional hydration24h before operation.group B: Based on the conventional hydration24h before operation and received Alprostadil Injection (20ug)30mins before operation.8.16and24h after operation,40ml saline diluted intravenous continuous infusion with20ng/kg/min. All patients blood urea nitrogen (BUN)、serum cysteine inhibin (Cys-C)、 serum creatinine (Scr) and β2microglobulin (β2-MG) were measured before operation,12,24and48h after operation. Evaluate glomerular filtration rate (eGFR) was caclulated according to the modified MDRD of 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 atfer operation12h,24h,48h, Scr、 atfer operation48h Cys-C and β2-MG were higher compared to baseline (P＜0.05). In group B after operation12h,24h, and48h, Cys-C, and β2-MG were higher compared to baseline(p>0.05),but was lower than group A after operation48h (P<0.05). In group B, Scr was higher than group A after operation24h and48h (P<0.05),but eGFR was higher than group A after operation24h and48h (P＜0.05). Conclusions:(1) On contrast media-induced renal dysfunction in coronary heart disease combined with diabetic patients undergoing coronary artery intervention therapy;(2) Diabetes and hypertension are independent risk factors for CIN;(3) Compared with hydration, hydration with alprostadil injection is more effectively in preventing the occurrence of CIN in Coronary Heart Disease combined with diabetic patients.