早期胱抑素C检测指导水化疗法预防造影剂肾病

目的:根据胱抑素C(Cys C)水平调整造影术后补液方案,观察其预防造影剂肾病(CIN)的效果。方法:280例冠状动脉造影患者随机分为常规水化组和指导水化组各140例,前者根据造影剂用量指导补液量,后者根据术后8h血清Cys C水平指导补液量,检测术前及术后8h、24h、48h血清Cys C及血清肌酐(SCr)水平,并进行比较分析。结果:常规水化组输液量较指导水化组多[(828.4±344.6)ml∶(746.6±308.2)ml,P<0.05];常规水化组有7例发生CIN,4例发生心力衰竭,而指导水化组无一例发生CIN及心力衰竭。结论:根据Cys C水平调整造影术后水化方案,能有效预防CIN的发生,并可避免过多输液加重心脏负担。

Early detection of cystatin C prevents contrast-induced nephropathy through hydration therapy

Objective:To determine the proposal of fluid infusion according to the concentration of cystatin C after coronary angiography and investigate the effect of preventing contrast-induced nephropathy(CIN).Method:A total of 280 patients was divided randomly into conventional hydration therapy group and guiding hydration therapy group averagely.Patients accepted fluid infusion according to the volume of contrast agent in conventional group whlie in guiding group according to the level of Cystatin C at 8 h after coronary angiography.Detecting and ananysing the levels of Cystatin C and SCr in serum before coronary angiography and 8 h,24 h and 48 h later.Result:Infusion volume of conventional hydration therapy group was more than guiding hydration therapy group [(828.4±344.6)ml∶(746.6±308.2)ml,P<0.05].There were 7 patients befalling in CIN and 4 in heart failure in conventional hydration therapy group while none occurred the same situation in guiding hydration therapy group.Conclusion:Concentration of Cystatin C determines the proposal of fluid infusion after coronary angiography,which could prevent CIN effectively and avoid excessive infusion and reduce the burden on the heart.