低渗与等渗对比剂对对比剂肾病患者肾功能的影响  

The clinical research of hypotonic and isotonic contrast agent-in contrast-induced nephropathy

作　　者：刘华东 董少红[1,2] 罗林杰 姜昕[1,2] 

机构地区：[1]深圳市人民医院 [2]暨南大学第二临床医学院心内科,广东深圳518020

出　　处：《中国当代医药》2010年第21期6-8,共3页China Modern Medicine

摘　　要：目的:观察低渗及等渗对比剂对高危对比剂肾病患者肾功能的影响。方法:选择2007年1月～2009年12月于本院接受冠状动脉造影(CAG)和(或)介入治疗(PCI)的患者,按照MehranR等归纳的对比剂肾病高危因素评分标准,选择评分>10分的患者196例,随机分为低渗组及等渗组。其中,低渗组114例,等渗组82例,两组患者术前及术后72h均测定血清肌酐(Scr)及半胱氨酸蛋白酶抑制剂C(CysC)水平,计算肾小球滤过率(GFR)及对比剂肾病发生率。结果:两组术后Scr及CysC平均峰值水平较术前有所升高,GFR平均值降低。其中低渗组Scr峰值平均升高16.9μmol/L,CysC平均峰值增加0.18mg/L,GFR峰值平均降低18.2%;等渗组Scr峰值平均升高14.7μmol/L,CysC平均峰值增加0.17mg/L,GFR峰值平均降低16.8%。低渗组对比剂肾病发病率为31.6%,等渗组对比剂肾病发病率为28.0%,二者比较差异无统计学意义(P>0.05)。结论:高危人群对比剂肾病的发生率明显增加,但低渗与等渗对比剂在高危患者中对肾功能的影响无明显差异。Objective：To observe the hypotonic and isotonic contrast agent contrast-induced nephropathy in high-risk patients with renal function.Methods：From January of 2007 to 2009 year in December on patients who underwent coronary angiography （CAG） and （or） intervention （PCI） patients,according to R Mehran and other inductive risk factors for contrast nephropathy score,select the score 10 196 cases of patients were randomly divided into groups and isotonic hypotonic group.One group of 114 cases of hypotonic,isotonic 82 patients,two groups of patients before and after 72 h were serum creatinine （Scr） and cysteine protease inhibitor C （CysC） levels,calculated glomerular filtration rate （GFR） and the incidence of contrast nephropathy.Results：The mean postoperative peak levels of Scr and CysC be higher than that properatively,GFR decreased.The average peak value of which increased permeability group Scr 16.9 μmol/L,CysC average peak increase of 0.18 mg/L,GFR decreased by 18.2% on average peak;isotonic group average peak Scr increased 14.7 μmol/L,CysC average peak increase of 0.17 mg/L,GFR decreased the peak average of 16.8%.Permeability contrast nephropathy group was 31.6%, isotonic contrast agent nephropathy group was 28.0%,the difference was not statistically significant （P0.05）.Conclusion： Contrast-induced nephropathy in high-risk groups are significantly increased,but low permeability and isotonic contrast media in high-risk patients on the renal function is no significant difference.

关 键 词：对比剂 对比剂肾病 危险因素 冠状动脉介入诊疗术 

分 类 号：R692[医药卫生—泌尿科学]