碳酸氢钠预防重症患者水化后造影剂肾病的临床效果  

Efficacy of sodium bicarbonate in prevention of contrast-induced nephropathy in critically ill patients under hydration

作　　者：徐志平[1] 刘励军[1] 朱凌霞 王小刚[1] 

机构地区：[1]苏州大学附属第二医院急重症医学科,江苏省215004

出　　处：《江苏医药》2014年第24期3007-3009,共3页Jiangsu Medical Journal

摘　　要：目的探讨静脉滴注碳酸氢钠预防重症患者水化后造影剂肾病(CIN)的临床效果。方法将223例行增强CT检查的重症患者分为水化组(A组,86例)和水化情况下静脉滴注5%碳酸氢钠250ml组(B组,137例),检测检查前及增强CT后第1、2、3、5天的血清肌酐(SCr)和肾小球滤过率(GFR),比较两组的CIN发生率。结果与A组相比,B组增强CT检查后第2、5天SCr增加值较小,而第2、3、5天GFR增加值较大(P<0.05)。B组CIN的发生率低于A组(9.5%vs.30.2%)(P<0.05)。结论使用造影剂前,在水化的情况下使用碳酸氢钠能有效保护受检重症患者的肾功能。Objective To investigate the efficacy of sodium bicarbonate in the prevention of contrast-induced nephropathy（CIN）in critically ill patients under the condition of hydration.Methods A total of 223 critically ill patients underwent contrast-enhanced CT examination was randomly divided into two groups of A（treated with hydration,86cases）and B（treated with intravenous infusion of 5% sodium bicarbonate 250 ml after hydration,137cases）.Serum creatinine（SCr）and glomerular filtration rate（GFR）were deteted before and on the 1st,2nd,3rd and 5th day after contrastenhanced CT examination.The incidence of CIN was compared.Results Compared with group A,the changes in the increase of SCr was less on the 2ndand 5th day after contrast-enhanced CT,while the changes in the increase of GFR was more on the 2nd,3rd and 5th day in group B（P〈0.05）.The incidence of CIN in group B was lower than that in group A（9.5% vs.30.2%）（P〈0.05）.Conclusion Under the condition of hydration,the administration of sodium bicarbonate can effectively protect renal function in the critically ill patients undergoing contrast-enhanced CT examination.

关 键 词：造影剂肾病 水化 碳酸氢钠 

分 类 号：R692[医药卫生—泌尿科学]