碳酸氢钠片对冠状动脉造影后的肾脏保护作用  

Renal protective effects of sodium bicarbonate tablets after coronary artery angiography

作　　者：王鹏 刘安恒 罗建平 石红坡 郭勍 WANG Peng;LIU Anheng;LUO Jianping;SHI Hongpo;GUO Qing(Department of Cardiology,Beijing Jingmei Group General Hospital,Beijing 102300,China)

机构地区：[1]北京京煤集团总医院心内科,北京102300

出　　处：《中国临床研究》2023年第11期1688-1690,1694,共4页Chinese Journal of Clinical Research

基　　金：北京京煤集团总医院院级科研项目(2020-21)。

摘　　要：目的探讨冠状动脉粥样硬化性心脏病(CHD)合并轻中度肾功能不全患者冠脉造影检查围手术期接受口服碳酸氢钠片联合水化治疗对造影剂肾病是否有预防作用。方法选取2020年6月至2022年12月北京京煤集团总医院收治的合并轻中度肾功能不全的CHD患者共100例。随机分为两组,试验组围手术期给予水化联合口服碳酸氢钠片治疗(n=46),对照组单纯水化治疗(n=54)。两组水化治疗速度均为1 mL/(kg·min),比较两组造影剂肾病发生率的差异。结果两组患者均成功完成手术,围手术期无紧急血液透析、急性心肌梗死、急性心力衰竭等严重事件发生。两组性别、年龄、术前血肌酐、糖尿病、造影剂量差异无统计学意义(P>0.05)。试验组46例患者无造影剂肾病发生,对照组54例患者有8例发生造影剂肾病(发生率为14.8%),两组比较差异有统计学意义(χ^(2)=5.531,P<0.05)。结论CHD患者冠状动脉造影围手术期给予碳酸氢钠片联合水化治疗对肾功能有保护作用,可以减少造影剂肾病的发生。Objective To explore whether oral sodium bicarbonate tablets combined with hydration therapy during the perioperative period of coronary angiography in patients with coronary heart disease(CHD)and mild to moderate renal insufficiency have a preventive effect on contrast induced nephropathy(CIN).Methods A total of 100 patients with CHD and mild to moderate renal insufficiency admitted to Beijing Jingmei Group General Hospital from June 2020 to December 2022 were selected.They were randomly divided into two groups,the experimental group(n=46)received hydration therapy combined with oral sodium bicarbonate tablets during the perioperative period,and the control group(n=54)received hydration therapy alone.The hydration rate in both groups was 1 mL/(kg·min).The incidence of CIN was compared between the two groups.Results Both groups of patients successfully completed the surgery,and no serious events such as emergency hemodialysis,acute myocardial infarction,or acute heart failure occurred during the perioperative period.There were no statistically significant differences in gender,age,preoperative creatinine,diabetes,or contrast agent dose between two groups(P>0.05).In the experimental group,none of the 46 patients developed CIN,while in the control group,8 out of 54 patients developed CIN(incidence rate of 14.8%).The difference between the two groups was statistically significant(χ^(2)=5.531,P<0.05).Conclusion Perioperative administration of sodium bicarbonate tablets combined with hydration therapy in CHD patients with coronary angiography has a protective effect on renal function and can reduce the occurrence of CIN.

关 键 词：冠状动脉粥样硬化性心脏病 碳酸氢钠片 冠状动脉造影 肾功能不全 造影剂肾病 

分 类 号：R514.1[医药卫生—内科学]