等渗与低渗造影剂对慢性肾功能不全患者肾毒性的对比研究  

Comparative Study of Nephrotoxicity of Isotonic and Hypotonic Contrast Agents in Patients with Chronic Renal In⁃sufficiency

作　　者：杜森 DU Sen(Department of Medical Imaging,The First Affiliated Hospital of Henan University,Kaifeng,Henan,475000,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475000

出　　处：《黑龙江医学》2023年第7期819-821,共3页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关计划项目(2018020313)。

摘　　要：目的:探究等渗与低渗造影剂对慢性肾功能不全患者肾毒性的影响。方法:选取2020年5月—2021年8月河南大学第一附属医院神经内科住院治疗的80例缺血性脑血管病患者进行研究,按照随机分组法分为等渗透压组及低渗透压组,每组各40例。分别记录术前、术后24 h、术后48 h、术后72 h血清胱抑素C(Cys C),血肌酐(SCr)水平。结果:等渗透压组Cys C在术后24 h、术后48 h、术后72 h分别为(1.58±0.29)mg/L、(1.02±0.22)mg/L、(0.79±0.22)mg/L,低渗透压组分别为(1.98±0.27)mg/L、(1.44±0.21)mg/L、(1.18±0.24)mg/L,将两组患者术后24 h、术后48 h、术后72 h的Cys C分别进行对比,等渗透压组均明显低于低渗透压组,差异有统计学意义(t=6.285,8.734,7.576,P<0.05)。等渗透压组SCr术后24 h、术后48 h、术后72 h分别为(73.9±3.1)μmoL/L、(80.9±4.9)μmoL/L、(73.8±4.9)μmo L/L,低渗透压组SCr术后24 h、术后48 h、术后72 h分别为(75.8±5.1)μmoL/L、(83.4±5.9)μmoL/L、(75.1±5.9)μmoL/L,等渗透压组均明显低于低渗透压组,差异有统计学意义(t=2.013,2.062,2.131,P<0.05)。结论:等渗透压造影剂较低渗透压造影剂有更低的肾毒性,尤其对于慢性肾功能不全的患者,优选等渗透压造影剂。Objective:To investigate the effect of isotonic versus hypotonic contrast agents on nephrotoxicity in patients with chronic renal insufficiency.Methods:80 patients with ischemic cerebrovascular disease who were hospitalized from May 2020 to August 2021 were selected for the study and were equally randomized into isotonic contrast group and hypotonic contrast group.Se⁃rum cystatin C(Cys C)and blood creatinine levels were recorded preoperatively,24 h postoperatively,48 h postoperatively,and 72 h postoperatively,respectively.Results:Cys C in the iso-osmolar group was(1.58±0.29)mg/L,(1.02±0.22)mg/L,(0.79±0.22)mg/L at 24 h,48 h and 72 h postoperatively,and(1.98±0.27)mg/L,(1.44±0.21)mg/L,(1.18±0.24)mg/L in the low osmolar group.Cys C in the iso-osmolar group was significantly lower than that in the hypo-osmolar group at 24 h,48 h and 72 h postoperatively,with statistically significant differences(t=6.285,8.734,7.576,P<0.05).The SCr in the iso-osmolar group was(73.9±3.1)μmoL/L,(80.9±4.9)μmoL/L,and(73.8±4.9)μmoL/L at 24 h,48 h,and 72 h postoperatively,and the SCr in the low osmolar group was(75.8±5.1)μmoL/L,(83.4±5.9)μmoL/L,(75.1±5.9)μmoL/L at 24 h,48 h,and 72 h postoperatively.The isotonic group was signifi⁃cantly lower than the low osmolarity group,and the difference was statistically significant(t=2.013,2.062,2.131,P<0.05).Conclusion:Iso-osmolar contrast agents have lower nephrotoxicity than low osmolarity contrast agents.Especially for patients with chronic renal insufficiency,iso-osmotic pressure contrast agents are preferred.

关 键 词：等渗造影剂 低渗造影剂 慢性肾功能不全 

分 类 号：R692[医药卫生—泌尿科学]