老年缺血性脑血管病患者血管造影中低渗非离子型造影剂对血肌酐、血尿素及肾功能的影响  

Effects of hypotonic nonionic contrast agents on serum creatinine,blood urea and renal function in elderly patients with ischemic cerebrovascular disease

作　　者：王萍[1] 段鲁勤[1] 王霞[1] 

机构地区：[1]泰安市中心医院老年病二科

出　　处：《中国生化药物杂志》2017年第7期401-402,405,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的分析老年缺血性脑血管病患者低渗非离子型造影剂血管造影对肾功能的影响,为临床治疗提高参考。方法选取本院2011年4月~2016年5月收治老年缺血性脑血管病患者100例为研究对象,患者均行脑血管、双肾动脉造影,检测造影术前3 d和造影术后不同时间血肌酐、尿素变化,并测定肾功能变化。结果 100例患者,12例患者出现造影剂肾病,发病率为12.0%。造影剂肾病组患者糖尿病比例、肾功能不全比例、重度肾动脉狭窄比例显著高于非造影剂肾病组（P〈0.05）。造影剂肾病组造影1 d、造影2 d血尿素、血肌酐和内生肌酐清除率均显著提高（P〈0.05）,到造影6 d逐渐恢复正常,非造影剂肾病组患者肾功能指标无明显变化。糖尿病（OR=6.973）、肾动脉重度狭窄（OR=4.286）、肾功能不全（OR=7.680）是造影剂肾病危险因素（P〈0.05）。结论老年缺血性脑血管病变患者使用低渗非离子型造影剂血管造影比较安全,糖尿病、肾功能不断患者需要注意肾功能指标变化。Objective To analyze the effect of serum creatinine,blood urea and renal function with angiography low permeability of non-ionic contrast agent in elderly patients with ischemic cerebrovascular disease,and provide reference for clinical treatment. Methods 100 elderly patients with ischemic cerebrovascular disease in hospital from April 2011 to May 2016 were selected,patient were given cerebrovascular,renal arteriography. The changes of serum creatinine and urea were detected at different time before and after 3 days,and the changes of renal function were detected. Results In100 cases,12 cases of contrast induced nephropathy,the incidence rate was 12%. Contrast nephropathy in patients with diabetes mellitus group proportion,renal insufficiency,the proportion of severe renal artery stenosis was significantly higher than the proportion of non contrast nephropathy group（ P〈 0. 05）. Contrast nephropathy group contrast 1 days and contrast 2 days blood urea,serum creatinine and creatinine clearance rate were significantly increased（ P〈 0. 05）,contrast to 6 days gradually returned to normal,no obvious change of non contrast nephropathy in patients with renal function index. Diabetes mellitus（ OR = 6. 973）,severe renal artery stenosis（ OR = 4. 286） and renal insufficiency（ OR = 7. 680） are the risk factors of contrast induced nephropathy（ P〈 0. 05）. Conclusion Vascular elderly patients with ischemic cerebrovascular disease using non-ionic contrast medium hypotonic angiography safer,diabetes,renal patients need to continue to pay attention to changes in renal function.

关 键 词：缺血性脑血管病 血管造影 血肌酐 肾功能 

分 类 号：R592[医药卫生—老年医学]