等渗造影剂碘克沙醇对老年冠状动脉性心脏病并慢性肾衰竭介入治疗肾功能的影响  

Effect of Iodixanol on renal functions of percutaneous coronary intervention-treated old patients with coronary artery heart disease and chronic renal insufficiency

作　　者：韦福起 

机构地区：[1]辽宁盘锦市第一人民医院心血管内科,124000

出　　处：《上海医学》2009年第3期246-248,共3页Shanghai Medical Journal

摘　　要：目的观察碘克沙醇在老年冠状动脉性心脏病(简称冠心病)并慢性肾衰竭介入治疗患者中应用的有效性和安全性。方法选择2005年4月-2008年3月行经皮冠状动脉介入治疗(PCI)的老年冠心病并慢性肾衰竭患者166例,均分为对照组(应用碘普罗胺)和观察组(应用碘克沙醇),观察两组间介入治疗前及术后3 d血清肌酐、尿素氮、内生肌酐清除率、血β2-微球蛋白和24 h尿蛋白定量。通过造影剂肾病(CIN)的发生例数评价肾功能恶化的情况。结果两组介入治疗均获成功。对照组PCI术后血清肌酐、尿素氮、内生肌酐清除率、血β2微球蛋白和24 h尿蛋白定量均显著高于本组术前及观察组术后(P值均<0.01),而观察组PCI前、后各项指标的差异均无统计学意义(P值均>0.05)。166例患者中,共25例患者出现CIN。对照组的CIN发生率为27.7%(23/83),显著高于观察组的2.4%(2/83,P<0.01)。无1例需透析治疗,均经药物治疗后好转出院。结论碘克沙醇应用于行介入治疗的老年冠心病并慢性肾衰竭患者安全、有效。Objective To evaluate the effectiveness and safety of Iodixanol in treatment of old patients with coronary artery heart disease （CHD） and chronic renal insufficiency （CRI） who were treated by percutaneous coronary intervention （PCI）. Methods Changes in renal functions in 166 patients with CHD and CRI, who were treated by PCI during April 2005 to March 2008, were include in our study. The patients were evenly divided into two groups： control group （Iopromide group） and test group （Iodixanol group）. The serum creatinine （Cr）, blood urea nitrogen （BUN）, 24 h urine protein （24 h UP）, endogenous creatinine clearance rate （Ccr） and β2- microglobulin （β2-MG） of patients were observed in the two groups before and 3 d after operation. The incidence of contrast-induced nephropathy （CIN） was used to evaluate the renal insufficiency. Results PCI was successful in all patients of two groups. After PCI, the Or, BUN, 24 h UP, Ccr and β2-MG in the control group were significantly higher than those before PCI and those in the test group after PCI （P〈0.01 ）; there were no significant differences in the test group before and after PCI. CIN was found in 25 patients after the procedures, and 23 （27.7%） of them were in the control group, which was significantly higher than that in the test group （5, 2.4% ） （P〈0.01 ）. There was no hemodialysis and all patients were discharged after medicinal treatment. Conclusion Iodixanol is safe and effective in treatement of old patients with CAD and CRI. （Shanghai Med J, 2009, 32： 246-248）

关 键 词：碘克沙醇 经皮冠状动脉介入 造影剂肾病 

分 类 号：R541.4[医药卫生—心血管疾病] R692.5[医药卫生—内科学]