水化对冠状动脉造影患者造影剂肾病的影响
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Study on Hydration in Prevention of Contrast-Induced Nephropathy After Coronary Angiography
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    目的观察水化对冠状动脉造影患者肾功能的影响及造影剂肾病的发生率。方法应用低渗非离子型造影剂碘海醇进行冠状动脉造影,将216例行冠状动脉造影或冠状动脉介入治疗患者随机分为两组:水化组112例,在常规补液基础上进行水化治疗;对照组104例,常规补液治疗,比较两组在造影前及造影后48 h、1周时血清肌酐、尿β2微球蛋白的浓度变化,观察两组造影剂肾病的发生率。结果水化组和对照组在造影后48 h血清肌酐、尿β2微球蛋白均升高,以对照组升高更显著。造影后1周两组均下降。水化组造影剂肾病发生率为4%,对照组为17%。结论加强水化能减轻肾功能伤害,减少造影剂肾病的发生率。

    Abstract:

    AimTo observe the effects of hydration on renal function and the incidence of contrast-induced nephropathy in patients undergoing coronary angiography.MethodsThe low osmolar and nonionic contrast media (iohexol) was used in all patients.A total of 216 patients, who would undergo coronary angiograph or percutaneous coronary interventional theraphy were enrolled into the study.They were randomly divided into two groups: the hydration group(n=112) and the control group (n=104).The treated group received hydration theraphy as well as general intravenous fluid infusion.The control group only received general intravenous fluid infusion.The levels of serum creatinine (Scr) and urine β2-microglobulin (β2MG) were measured before angiography and 48 hours, one week after coronary angiograpy.The incidence of contrast-induced nephropathy (CIN) was observed in the two groups.ResultsThe levels of Scr and β2MG were both elevated in the two groups, especially in the control group.The levels began to decrease after one week.The incidence of CIN was 4% in hydration group, 17% in control group.ConclusionThe strengthened hydration therapy can reduce the renal damage and effectively prevent from contrast-induced nephropathy.

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刘天华,戚保桥,史骏,刘新兵,黄红漫,冯六六,周明成.水化对冠状动脉造影患者造影剂肾病的影响[J].中国动脉硬化杂志,2012,20(9):840~842.

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  • 收稿日期:2011-10-08
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