等渗及低渗造影剂对高危患者发生造影剂肾病的对比  

Comparison of the effects of Isoosmotic and hypotonic contrast agents on the occurrence of contrast Agent Nephropathy in High risk patients

作　　者：张劭彦 ZHANG Shaoyan(High risk patients ZHANG Shaoyan)

机构地区：[1]广东省惠州市第一人民医院放射科,广东惠州516001

出　　处：《中国医药科学》2018年第11期207-209,共3页China Medicine And Pharmacy

摘　　要：目的探讨等渗及低渗造影剂对高危患者发生造影剂肾病的临床对比研究。方法临床纳入2015年9月~2017年7月期间本院收治的86例行冠状动脉造影术的慢性肾功能不全患者,按随机数字表法分为研究组和常规组,每组各43例。研究组给予等渗造影剂进行造影术检查,常规组给予低渗造影剂进行造影术检查,并将两组造影剂肾病(CIN)发生率、注射造影剂后Scr水平变化、不良反应发生率进行对比。结果研究组CIN发生率为2.33%,明显对于常规组的13.95%,组间比较差异有统计学意义(χ~2=9.029、P=0.003);研究组及常规组在术后第1、3、7天的Scr浓度变化比较差异有统计学意义(t=-2.439、P=0.017,t=-2.128、P=0.036,t=-3.050、P=0.003);研究组术后第1、3、7天的Ccr水平均明显高于常规组,差异有统计学意义(t=2.120、P=0.037,t=2.055、P=0.043,t=2.042、P=0.044);研究组患者不良反应发生率明显低于常规组,组间比较差异有统计学意义(χ~2=11.881、P=0.000)。结论相较于低渗造影剂,等渗造影剂的运用对降低造影剂肾病发生率、改善血清肌酐浓度等方面均具有积极意义,且安全性较高,无明显不良反应,具备较高临床运用价值。Objective To investigate the effect of isosmotic and hypotonic contrast agents on high-risk patients with contrast agent nephropathy.Methods From September 2015 to July 2017,86 patients with chronic renal insufficiency underwent coronary angiography were enrolled in the study.According random number table method,were randomly divided into study group and control group,each of 43 cases.The study group was given isosmotic contrast agent and the routine group was given hypotonic contrast agent.The incidence of CINs,the level of SCR and the incidence of adverse reactions were compared between the two groups.Results The incidence of CIN in the study group was 2.33%,which was significantly higher than that in the control group(χ2=9.029,P=0.003).There were significant differences in SCR concentration between the study group and the routine group on the 1st,3rd and 7th day after operation(t=-2.439、P=0.017,t=-2.128、P=0.036,t=-3.050、P=0.003).On the 1st,3rd and 7th day after operation,the levels of CCR in the study group were significantly higher than those in the control group(t=2.120、P=0.037,t=2.055、P=0.043,t=2.042、P=0.044),the difference was statistically significant.The incidence of adverse reactions in the study group was significantly lower than that in the routine group(χ2=11.881、P=0.000).Conclusion Compared with hypotonic contrast agent,the application of isosmotic contrast agent has positive significance in reducing the incidence of contrast agent nephropathy and improving serum creatinine concentration,and has high safety,no obvious adverse reaction,and has high clinical application value.

关 键 词：等渗 低渗 造影剂 高危 造影剂肾病 

分 类 号：R595.3[医药卫生—内科学]