造影剂温度对经皮冠状动脉介入治疗患者造影剂肾病发病率的影响

目的 探讨造影剂温度对造影剂肾病（CIN）发病率的影响。方法 将157例经皮冠状动脉介入（PCI）治疗患者随机分为20℃碘克沙醇组（20℃组,n=77）和37℃碘克沙醇组（37℃组,n=80）。 分别于PCI术前、后行血液流变学指标检测;PCI术前24 h内、术后12、24 和48 h检测血浆胱抑素C和肌酐。分析两种温度造影剂对患者肾功能和血液流变学指标的影响。结果 20℃组PCI术后24 h的胱抑素C、48 h的肌酐显著高于术前(P<0.05),全血高切、低切表观黏度亦显著较术前升高,差异有统计学意义（P<0.05）。 37℃组PCI术后24 h的胱抑素C、48 h的肌酐低于20℃组相应时间点水平,且PCI术后全血高切、低切表观黏度亦低于术后20℃组,具有统计学意义（P<0.05）。37℃组CIN发生率（2%）显著低于20℃组（8%）,具有统计学意义（P<0.05）。结论 37℃碘克沙醇的CIN发生率显著低于20℃碘克沙醇。

Effects of contrast temperature on prevalence of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention

AIM To investigate the effects of contrast temperature on the prevalence of contrast-induced nephropathy (CIN). METHODS A total of 157 patients who underwent percutaneous coronary intervention were randomly divided into 20℃ iodixanol group (n=77) and 37℃ iodixanol group (n=80). Hemorheology indexes were determined prior and post-index procedure, respectively. Meanwhile, serum cystatin C and creatinine were also detected within 24 h prior to index procedure and at 12, 24, and 48 h post-index procedure, respectively. The effects of two types of contrast temperature on renal function and hemorheology indexes were analyzed. RESULTS Serum cystatin C at 24 h post-procedure and creatinine at 48 h post-procedure were higher than pre-procedure in 20℃ iodixanol group, which were both statistically significant (P<0.05). Compared to pre-procedure, both high and low shear rate blood viscosity post-procedure were statistically significantly increased in 20℃ iodixanol group. Serum cystatin C at 24 h post-procedure and creatinine at 48 h post-procedure in 37℃ group were significantly lower than in the 20℃ group, respectively (P<0.05). Compared to the 20℃ group post-procedure, both high and low shear rate blood viscosity post-procedure were statistically significantly lower in 37℃ iodixanol group (P<0.05). The prevalence of CIN in 37℃ iodixanol group was statistically significantly lower than in the 20℃ iodixanol group (2% vs. 8%, P<0.05). CONCLUSION The prevalence of CIN in the 37℃ iodixanol group is significantly lower than in the 20℃ iodixanol group.