前列地尔联合水化预防老年肾功能不全患者对比剂肾病的临床观察  

Clinic observation of the effects of Alprostadil jointed hydration on preventing contrast introduced Nephropathy in elderly patients with renal insufficiency

作　　者：严红英[1] 陈双琴[1] 杨定平[2] 

机构地区：[1]湖北省襄阳市中心医院北区肾内科,441003 [2]武汉大学人民医院肾内科,430060

出　　处：《临床肾脏病杂志》2014年第9期547-550,共4页Journal Of Clinical Nephrology

基　　金：湖北省自然基金（NO.2012FFB04426）

摘　　要：目的 观察老年肾功能不全患者造影后给予前列地尔联合水化对于对比剂肾病的预防作用.方法 将40例肾功能不全的老年患者（＞65岁）随机分为2组,分别为联合组21例,水化组19例.联合组采用前列地尔加水化预防,水化组采取水化预防,观察2组患者对比剂肾病的发生率和造影前及造影后3d血清肌酐、尿素氮和胱抑素C的变化.结果 水化组造影后24 h、48 h、72 h检测结果分别是尿素氮（14.37±3.98） mmol/L,（18.31±4.06） mmol/L,（20.43±4.72） mmol/L;血清肌酐（240±70.85）μmol/L,（410±75.36）μmol/L,（471±82.73） μmol/L;胱抑素C（2.32±0.37）mg/L,（2.01±0.31） mg/L,（1.85±0.28） mg/L.联合组造影后24 h、48 h、72 h检测结果分别是尿素氮（13.47±3.82） mmol/L,（15.87±5.23） mmol/L,（17.04±4.8）mmol/L;血清肌酐（210.24±69.61）μmol/L,（328.67±68.34）μmol/L,（365.32±78.27）μmol/L;胱抑素C（1.90±0.42） mg/L,（1.69±0.39）mg/L,（1.48±0.40） mg/L.联合组和水化组于造影后24 h内血清肌酐、尿素氮上升不明显,于48 h上升明显,72 h达高峰.联合组血清肌酐、尿素氮与水化组比较,差异有统计学意义（P＜0.05）.联合组和水化组胱抑素C在造影后24 h达高峰,随后逐渐下降.联合组胱抑素C与水化组比较,差异有统计学意义（P＜0.05）.联合组发生对比剂肾病4例,水化组8例,对比剂肾病的发生率分别为19.04％和42.1％,2组比较差异有统计学意义（P＜0.01）.结论 肾功能不全的老年患者在给予对比剂检查后立即给予前列地尔治疗对于预防对比剂肾病有一定疗效.Objective To observe the effects of the elderly patients with renal insufficiency after giving Alprostadil jointed hydration on preventing contrast nephropathy.Methods 40 cases of elderly patients with renal insufficiency（over 65） were randomly divided into two groups,the joint group （n=21） use Alprostadil jointed hydration to prevent contrast introduced nephropathy,hydration group （n=19） take hydration to prevent introduced nephropathy.To observe of contrast nephropathy and their serum levels of creatinine,urea,cystatic C were measured before and 3 d after contrast examination.Results Joint and hydration group contrast nephropathy rates were 19.04％ and 42.1％ respectively,comparing the two groups have significant difference（P＜0.01）.Joint and hydration groups within 24h after screening serum creatinine and urea nitrogen rise is not obvious,at 48 h rise more apparent,72h peak.But the joint group compared with hydrated group,serum creatinine and urea nitrogen was statistically significant difference（P＜0.05）.Joint group and hydration cystatin C within 24 h of imaging of peak and then decline gradually,but joint group cystatin C compared with that of hydrated group,the difference was statistically significant（P＜0.05）.Conclusions Elderly patients with renal insufficiency receiving immediately alphrostadil jointed hydration treatments after contrast examination can effectively prevent contrast nephropathy.

关 键 词：对比剂肾病 预防 老年人 

分 类 号：R692[医药卫生—泌尿科学]