摘要
目的观察及分析碘普罗胺在冠脉介入中对肾毒性的影响。方法对应用碘普罗胺行冠脉造影中1 761例患者术前行肾功能、尿液分析检查均正常,术后给患者充分水化,术后3 d内行肾功能、尿液分析检查并进行分析,同时对性别、年龄、民族,伴发糖尿病、高血压、高脂血症疾病进行调查。结果发现有182例发生CIN,发病率10.43%。对此进行回顾性分析:碘普罗胺造影剂剂量≤50 m L的758例患者59例患病;剂量51~100 m L的659例患者69例患病,剂量>100 m L的患者354例患者有54例患病,经χ2检验不同剂量造影剂者发生造影剂肾病发病差异有统计学意义(χ2=14.630,P<0.05)。伴有糖尿病患者310例患病44例,发生率为14.19%;不伴发糖尿病1 451例中患病138例,发生率9.51%,糖尿病患者与非糖尿病患者间造影剂肾病的发病差异有统计学意义(χ2=6.044,P<0.05);伴有或无高血压、高脂血症患者差异统计学无意义;不同年龄、性别、民族之间,差异无统计学意义。结论采用>100 m L碘普罗胺及伴发糖尿病患者行冠脉介入易发生CIN,因此在进行冠脉介入造影时不仅要充分水化,同时考虑患者的并发症、减少造影剂的用量,对伴有糖尿病患者尽可能减少剂量或不进行冠脉造影。
Objective To observe and analyze the effects on renal toxicity of iopromide in coronary intervention. Methods Adequate hydration was given to 1761 patients with normal preoperative renal function,urine analysis tests were performed and patients were accepted iopromide coronary angiography,and then the renal function was tested,urine analysis was performed within 3 days after surgery,and at the same time,surveyed patients ’ data about age, nationality, gender, hypertension and diabetes hyperlipidemia.Results There were 182 cases of CIN( 10. 43%). Then had retrospectively analyzed the results,there were 59 cases out of 758 patients in iopromide contrast agent dose was smaller than 50ml; there were 69 cases out of 659 patients in iopromide contrast agents dose between 51 and 100ml; there were 54 cases out of 354 patients in iopromide contrast agent dose dose > 100 ml. The incidence of difference of iopromide nephropathy of different doses patients had significant differences( χ2= 14. 630,P < 0. 05); There were 44 cases out of310 patients with diabetes( 14. 19%),and there were 138 cases out of 1451 patients without diabetes( 9. 51%). The iopromide Nephropathy incidence of difference in diabetic and non- diabetic patients had significant differences( χ2= 6. 044,P < 0. 05); the iopromide nephropathy incidence of difference in patients with or without hypertension,hyperlipidemia had no significant differences. The iopromide nephropathy incidence of difference between different ages,sex,and nationality had no significant differences.Conclusion There might be high CIN incidence to give iopromide in coronary intervention to the patients who associated with diabetes with > 100 ml dose. Adequate hydration should be given to patients with diabetes to reduce the dosage of contrast medium.
出处
《宁夏医学杂志》
CAS
2015年第4期303-305,共3页
Ningxia Medical Journal
基金
宁夏自然科学基金资助项目(NX13200)
关键词
冠脉介入
对比剂
肾毒性
coronary intervention
Contrast agent
Contrast-induced nephropathy
