摘要
目的探讨不同程度慢性肾功能不全(CKD)合并冠心病患者的临床特征及行冠状动脉介入术(PCI)前后血肌酐的变化。方法选择102例CKD且行PCI的患者,术后随访1个月,分析肌酐变化。肾功能不全程度按血肌酐水平分为轻中重组。轻度CKD组(1组)PCI前后给予水化处理;中度CKD组(2组)PCI前后给予水化处理,同时给予康注射液、百令胶囊、海昆肾喜、开同等改善肾功能药物治疗;重度CKD组(3组)给予1组+2组处理的同时给予血液透析。结果不同程度CKD合并冠心病患者中男性比例高;重度CKD组年龄较小;中重度CKD中三支病变比例高;轻度CKD组中双支病变比例高。101例患者均成功完成介入手术,2例重度CKD患者分别于术中及术后2 d死亡,共有3例发生造影剂肾病,术后1个月三组患者血肌酐水平较入院比较差异未见统计学意义。结论对不同程度CKD患者术前改善肾功能,可较好耐受PCI。
Objective To investigate the clinical characteristics of patients with chronic renal insufficiency and coronary heart disease(CHD) and the changes of creatinine levels before and after PCI.MethodsA total of 102 patients with chronic renal insufficiency underwent coronary intervention were followed up for at least one month. The changes of creatinine levels were analyzed. Renal insufficiency degrees were divided into mid group, moderated group and severe group by serum creatinine levels. The patients with mild renal insufficiency (group 1) were treated with hydration before and after PCI. Besides hydration, the patients in moderate renal insufficiency group (group 2)were given shenkang injection, Haikun Shenxi capsule, Ketosteril and so on to improve kidney function; the patients in severe renal insufficiency group (group 3) were treated with hemodialysis besides hydration and drugs like group 2.ResultsThe proportion of males was high in different degrees of renal dysfunction cornbined with coronary heart disease. The general data showed no significant difference. The severe renal insufficiency group had younger age, and the moderate and severe renal insufficiency group had high proportion of three vessels lesions the midl group had high proportion of double vessels disease. A total of 101 patients successfully completed the interventional procedures, 2 patients with severe renal insufficiency died in intraoperation and postoperative 2 days. There were 3 patients suffered from contrast-induced nephropathy(CIN). One month later, creatinine had no significant difference compared with those before hospitalization.ConclusionsTo improve renal function before PCI for patients with varying degrees of chronic renal insufficiency, can make the patients better tolerate PCI.
出处
《中国实用医刊》
2017年第22期30-33,共4页
Chinese Journal of Practical Medicine
关键词
慢性肾功能不全
不同程度
冠心病
冠状动脉介入术
肌酐
Different degree
Chronic renal insufficiency
Coronary heart disease
Percutaneous coronary intervention
Creatinine