尼莫地平对脑血管介入诊疗术后对比剂肾病预防的临床观察  

Nimodipine injection on the prevention of contrast induced nephropathy in patients with cerebral vascular disease undergoing interventional diagnosis and treatment

作　　者：陈晓 杨敏 付睿[2] 戴威[2] 

机构地区：[1]国家康复辅具研究中心附属康复医院内科,北京100176 [2]首都医科大学附属北京世纪坛医院神经内科,北京100038

出　　处：《中国临床医生杂志》2013年第8期22-24,共3页Chinese Journal For Clinicians

摘　　要：目的观察尼莫地平注射液对接受脑血管介入诊疗患者术后肾功能的影响。方法 162例接受脑血管介入诊疗患者随机分为研究组(n=82)和对照组(n=80)。两组均常规水化,研究组在使用对比剂前开始到术后24小时给予尼莫地平注射液静脉持续泵入(0.5～1mg/h)。比较两组术后(24小时、48小时)血肌酐(SCr)值及血胱抑素C(CysC)、术后SCr峰值、SCr增高值(△SCr)以及对比剂肾病(CIN)发生率。结果研究组术后24小时和48小时CysC、48小时Scr显著低于对照组(P分别为0.001、0.024、0.031),术后SCr峰值、△SCr也显著低于对照组(P分别为0.001、0.001)。对照组CIN发病率明显高于研究组,两组之间差异有显著性(P=0.040)。结论尼莫地平注射液对脑血管介入诊疗术后对比剂肾损害有一定的预防作用。Objective To study the role of nimodipine injection on contrast induced nephropathy in patients with cerebral vascular disease undergoing interventional diagnosis and treatment.Method A total of 162 cerebral vascular disease undergoing interventional diagnosis and treatment were randomly assigned into nimodipine group and control group to receive nimodipine injection pumping for 24h（0.5~1mg/h） applicatively or hydration with intravenous saline alone.At 24h,48h after contrast agent administration,the parameters of renal function were measured including serum cystatin C,creatinine,the post-procedure mean peak of Scr and the post-procedure increasing Scr from baseline（△SCr）and the incidence of CIN.Result At 24h and 48h after contrast administration,the levels of serum cystatin C,creatinine were significantly lower in nimodipine group than in the control group,at 48h after contrast administration（P=0.001、0.024）,we could get the same conclusion in the levels of serum creatinine（P=0.031）.The levels of the post-procedure mean peak of Scr and △SCr after contrast administration were significantly lower in nimodipine group than in the control group（P=0.001、0.001）The incidence of contrast agent-induced nephropathy was significantly lower in nimodipine group than in the control group（16.3% vs.6.1%,P=0.040）.Conclusion Nimodipine injection offers protection against radiographic contrast agent-induced renal injury in patients with cerebral vascular disease undergoing interventional diagnosis and treatment.

关 键 词：脑血管 介入 对比剂肾病 尼莫地平 

分 类 号：R743[医药卫生—神经病学与精神病学]