EECP Effectively Reduces Serum Creatinine in Patients with Combined CKD and DM post CAG/PCI, and Increases the Glomerular Filtration Rate 體外反搏治療有效降低慢性腎臟病和 糖尿病 患者在CAG/PCI術後的血清肌酐水平、和增加腎小球過濾率

Source From 資料來源 : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618591/

EECP Effectively Reduces Serum Creatinine in Patients with Combined CKD and DM post CAG/PCI, and Increases the Glomerular Filtration Rate

OBJECTIVE:

To evaluate the efficacy of enhanced external counterpulsation (EECP) in the prevention of contrast-induced nephropathy (CIN) in patients with combined chronic kidney disease (CKD) and diabetes mellitus (DM) by comparing the changes in renal function-related indicators in patients before and after coronary angiography (CAG) or percutaneous coronary intervention (PCI).

METHODS:

There were 230 subjects consecutively included in the study. Of these, 30 cases with DM underwent rehydration therapy, and 200 cases underwent EECP therapy in addition to rehydration therapy, comprising 53 patients with DM and 147 patients without. All the patients were tested to measure the renal function indicators before and after CAG/PCI.

RESULTS:

The postoperative results of blood urea nitrogen (BUN), serum creatinine (Scr), estimated glomerular filtration rate (eGFR), B2 microglobulin, and high-sensitivity C-reactive protein in the three groups showed a statistically significant difference (P < 0.05). After EECP therapy, patients with DM showed a significant decrease in BUN (9.1 ± 4.2 vs. 7.2 ± 3.0, t = 3.899, P < 0.001) and a significant increase in eGFR (41.5 ± 12.7 vs. 44.0 ± 15.6, t = -2.031, P = 0.047), while the patients without DM showed a more significant difference (P < 0.001). Patients with DM showed a lower percentage of elevated Scr (66.7% vs. 43.4%, P = 0.042), a higher percentage of elevated eGFR (30.0% vs. 52.8%, P = 0.044), and a lower incidence of CIN (16.7% vs. 3.8%, P = 0.042) after EECP therapy.

CONCLUSION:

Treatment with EECP can reduce Scr in patients with combined CKD and DM post CAG/PCI, increase eGFR, and decrease the incidence of CIN.

「通過增強體外反搏降低慢性腎病和 糖尿病 患者造影劑誘發腎病的風險」

目標

通過比較冠狀動脈造影(CAG)或經皮冠狀動脈介入(PCI)術前後患者腎功能相關指標的變化,評估體外反搏治療(EECP)在預防合併慢性腎臟病(CKD)和 糖尿病 (DM)患者造影劑誘導的腎病療效。

方法

本研究連續納入230名患者,其中30名 糖尿病 患者接受補液治療,200名患者在補液治療基礎上接受EECP治療,包括53名 糖尿病 患者和147名非 糖尿病 患者。所有患者在CAG/PCI術前和術後進行腎功能指標的檢測。

結果

三組患者的術後結果顯示血尿素氮(BUN)、血清肌酐(Scr)、估計腎小球過濾率(eGFR)、B2微球蛋白和高敏C-反應蛋白的變化具有統計學意義。經過EECP治療後, 糖尿病 患者的BUN顯著降低,eGFR顯著增加,而非 糖尿病 患者的差異更顯著。經過EECP治療後, 糖尿病 患者的血清肌酐升高比例較低,較高的腎小球過濾率升高比例,以及較低的造影劑誘發的腎損傷﹙CIN﹚發生率。

結論

EECP治療可以降低合併慢性腎臟病和 糖尿病 的患者在CAG/PCI術後的Scr,增加eGFR,並降低CIN的發生率。

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