碳酸氢钠水化对对比剂肾病的预防作用研究

目的探讨对于行冠脉造影，介入患者，应用生理盐水和碳酸氢钠两种不同干预方法后对比剂肾病contrastinduced nephropathy，CIN）的发生率，验证并比较两种预防方法的有效性。方法将拟行冠脉造影／介入的患者210例，随机分为碳酸氢钠组（实验组，n=110例）和生理盐水组（对照组，n=100例）。两组分别给予1．25％碳酸氢钠注射液或0．9％氯化钠注射液，并测定造影前和造影后24h、48h的血清肌酐（Scr），比较两组患者CIN的发生率。结果两组患者共发生造影剂肾病17例（8．1％），其中碳酸氢钠组5例（4．5％），生理盐水组11例（12．0％）；两组造影剂肾病的发生率具有显著性差异（P〈0．05）。结论对于造影剂引发的急性肾损伤，在造影前采用碳酸氢钠进行水化预防比采用氯化钠水化预防更为有效。

Prophylactic effect of Hydration with sodium bicarbonate on contrast-induced nephropathy

Ahn To observe the incidence of contrast-induced nephropathy （CIN） in patients with coronary heart disease after intervention. Methods There 210 patients were assigned into two groups：the sodium bicarbonate（the treated group consisted of 110 cases） and the sodium chloride （the control groupcosnsited of 100 cases）before using contrast medium. The level of erum creatininel were measured at baseline before using contrast medium and 24 hour ,48 hour after using contrast medium. The incidence of CIN was compared between the two groups. Results The morbidity of CIN was 12.0% （12/100） in sodium chloride group while 4.5 % （5/110） in sodium bicarbonate group, There was a significant difference in the incidence of CIN between two groups（P=0.042）. Conclusions Hydration with sodium bicarbonate before contrast exposure is more effective than hydration with sodium chloride in the prevention of CIN.