稀释用碘克沙醇对冠心病合并慢性肾脏病患者经皮冠状动脉介入术后肾功能的影响  

Impact of dilute iodixanol on renal function after percutaneous coronary intervention in coronary heart disease patients complicated with chronic kidney disease

作　　者：朱凌波 胡钱国 ZHU Lingbo;HU Qianguo(Department of Cardiovascular Medicine,Huang Shan Chang Ren Hospital,Huangshan 245000,China)

机构地区：[1]黄山昌仁医院心内科,安徽省黄山市245000

出　　处：《临床合理用药杂志》2022年第24期16-18,22,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察稀释用碘克沙醇对冠心病合并慢性肾脏病(CKD)患者经皮冠状动脉介入术(PCI)后肾功能的影响及安全性。方法回顾性选取2019年11月—2021年11月黄山昌仁医院收治的冠心病合并CKD患者52例,CKD分期:3期27例,4期22例,5期3例。患者均行PCI,术中选取碘克沙醇注射液作为对比剂,并以0.9%氯化钠溶液进行1∶1稀释后应用。记录患者手术情况,并比较不同分期患者术前及术后24~72 h血尿素氮(BUN)、血肌酐(SCr)及估算肾小球滤过率(eGFR),观察患者对比剂诱发的急性肾损伤(CI-AKI)等不良反应及严重不良心脑血管事件发生情况。结果52例患者均顺利完成冠状动脉造影及PCI,且冠状动脉造影图像清晰,治疗成功率为100.0%。冠心病合并CKD患者术后e GFR高于术前(P<0.05);患者手术前后BUN、SCr比较,差异无统计学意义(P>0.05)。亚组分析结果显示,冠心病合并CKD 4期患者术后BUN、SCr低于术前,eGFR高于术前(P<0.05);冠心病合并CKD 3、5期患者手术前后BUN、SCr、eGFR比较,差异无统计学意义(P>0.05)。患者均未发生CI-AKI及其他不良反应,随访期间患者均未出现严重不良心脑血管事件。结论稀释用碘克沙醇对冠心病合并CKD患者肾功能的影响较小,安全可行。Objective To evaluate the impact of dilute iodixanol on renal function after percutaneous coronary intervention(PCI)in coronary heart disease patients complicated with chronic kidney disease(CKD).Methods From November2019 to November 2021,52 cases of coronary heart disease patients complicated with CKD underwent PCI were enrolled,CKD stage:3 stage with 27 cases,4 stage with 22 cases,5 stage with 3 cases.During the operation,iodixanol injection was used as contrast agent,and diluted with 0.9%sodium chloride solution at 1∶1 before application.Operation situation of patients were recorded,and BUN,SCr,eGFR before operation and at 24-72 h after operation were compared of patients with different stages,and the incidence of adverse reactions(including CI-AKI)and serious unconscionable cerebrovascular events were observed.Results All 52 patients successfully completed coronary angiography and PCI,and the images of coronary angiography were clear,with a successful rate of 100.0%.After operation,eGFR of patients was higher than that before operation(P<0.05);there was no significant difference of BUN,SCr of patients before and after operation(P>0.05).The subgroup analysis results showed that,BUN,SCr after operation of coronary heart disease patients complicated with CKD of 4 stage were lower than those before operation,eGFR was higher than that before operation(P<0.05);there was no significant difference of BUN,SCr,eGFR before and after operation of coronary heart disease patients complicated with CKD of 3 and 5 stage(P>0.05).None of the patients had CI-AKI and the other adverse reactions.During the follow-up period,none of the patients had serious unconscionable cerebrovascular events.Conclusion Diluted iodixanol has little effect on renal function of coronary heart disease patients complicated with CKD,which is safe and feasible.

关 键 词：慢性肾脏病 碘克沙醇 肾功能异常 经皮冠状动脉介入治疗 对比剂诱发的急性肾损伤 

分 类 号：R541.4[医药卫生—心血管疾病] R692[医药卫生—内科学]