摘要
目的探讨冠状动脉介入诊疗中不同剂量非离子型对比剂对肾功能的影响。方法选择行冠状动脉介入诊疗术(冠状动脉造影和/或冠状动脉支架植入术)的患者500例,其中男性280例,女性220例;年龄53～78岁,平均年龄65.0岁。单纯冠状动脉造影280例,冠状动脉造影+冠状动脉支架植入术220例。根据使用非离子型对比剂的剂量随机分为3组:低剂量组(<100 mL)180例,其中男性100例,女性80例,平均年龄60.2岁;中剂量组(100～200 mL)200例,男性110例,女性90例,平均年龄65.6岁;高剂量组(>200 mL)120例,男性70例,女性50例,平均年龄66.9岁。分别检测各组对比剂应用前及应用后8、12、24、48、72 h反映肾功能情况的血清肌酐(SCr)、胱抑素C(Cys C),比较每组内和组间不同时间段的SCr、Cys C。结果低剂量组中,SCr仅在对比剂应用后48 h升高,而Cys C仅在对比剂应用后24 h升高,且差异具有统计学意义(P<0.05),其他时段均与基线水平差异无统计学意义。与低剂量组相比,中剂量组血SCr、Cys C在各个时间段升高幅度明显增加(P<0.05),而高剂量组比中剂量组SCr、Cys C在各个时间段进一步升高(P<0.05),并且随着对比剂应用剂量的增加,如中剂量组和高剂量组其SCr、Cys C升高的程度均明显提高,差异具有统计学意义(P<0.05),且恢复速度明显变慢,部分患者对比剂应用72 h后仍未恢复到基线水平,并且较基线水平明显升高(P<0.05)。结论在冠状动脉介入诊疗中,应用非离子型对比剂对肾功能的损害与对比剂剂量明显相关,低剂量(<100 mL)对肾功能影响小且恢复快,而中剂量(100～200 mL)和高剂量(>200 mL)随着剂量的增加其对肾功能的影响越大,且恢复越慢,部分患者由对比剂造成的肾功能损害在一定时间内持续存在。
Objective To explore the different doses of non-ionic contrast agent on renal function during intervention therapy of coronary artery. Methods A total of 500 patients with coronary artery interventional procedures （coronary angiography and/or coronary artery stent implantation） were enrolled, male 280, female 220, aged 53 - 78 years old, mean age 65.0 years old. The 280 cases performed coronary angiography, and 220 cases performed coronary angiography ＋ coronary artery stent implantation. By theuse of contrast agent volume were randomly divided into 3 groups： the low dose group（〈 100 mL, n = 180）, male 100, female 80, mean age 60.2 years old; the moderate dose group（l00 - 200 mL, n = 200）, male 110, female 90, mean age 65.6 years old; the high dose group （〉 200 mL, n = 120 ）, male 70, female 50, mean age 66.9 years old, respectively. The kidney function was investigated by detecting andcomparing serum creatinine（SCr） and crystatin C（Cys C） before and after the application of contrast agents used at 8-hour, 12-hour, 24-hour, 48-hour and 72-hour. Results In low dose group, SCr was increased after applying contrast agent for 48 hours, while Cys C increased after applying contrast agent for 24 hours （P 〈 0.05）, other periods compared with baseline levels had no significantdifference. Compared with the low dose group, the blood SCr and Cys C of moderate dose in all of time segments were increased significantly（P 〈 0.05）, whereas the SCr and Cys C of high dose group in each time period were futher elevated than that of the moderate dose group（P 〈 0.05）. With the increase of contrast agent dose, the SCr and Cys C in moderate and high dose group were significantlyincreased（P 〈 0.05） and the recovery is significantly slow. Compared with baseline levels, the SCr and Cys C of some patients were significantly elevated （P 〈 0.05） and not return to baseline levels after applying contrast agent for 72-hour. Conclusion It is demonstrated that renal damage are signific
出处
《生物医学工程与临床》
CAS
2012年第2期137-139,共3页
Biomedical Engineering and Clinical Medicine
基金
安徽省卫生厅基金项目(09C189)
关键词
冠状动脉介入诊疗
非离子型对比剂
对比剂肾病
肾功能
coronary angiography and intervention
non-ionic contrast agent
contrast-induced nephropathy
renal function
