低渗与等渗对比剂对冠脉介入患者肾功能的影响

目的观察低渗及等渗对比剂对冠脉介入治疗患者肾功能的影响。方法选择2006年11月—2008年7月于我院接受冠脉介入治疗的患者398例,随机分为低渗组(A组)及等渗组(B组)。其中A组202例[男130例,女72例,平均(60.4±12.6)岁],B组196例[男118例,女78例,平均(61.2±13.5)岁];A组中术前肾功能正常者157例(77.7%A1组),肾功能异常者45例(22.3%A2组);B组中术前肾功能正常者148例(75.5%B1组),肾功能异常者48例(24.5%B2组);所有患者术前及术后72h均测定血清肌酐水平。结果A1组及B1组术后血清肌酐水平无明显变化;A2组术后血清肌酐水平明显增高(P<0.05);B2组术后血清肌酐水平有所升高,但无统计学意义(P>0.05)。结论应用等渗对比剂可降低对比剂肾病的发生率。

Influences of Low-osmolar versus Iso-osmolar Contrast Media on Renal Function of Patients Following Percutaneous Coronary Intervention

Objective To study the influences of low-and iso-osmolar contrast media on renal function of patients following percutaneous coronary intervention (PCI). Methods We enrolled 398 patients who had underwent PCI from November 2006 to July 2008. The patients were randomly divided into low-osmolar group (Group A) and iso-osmolar group (Group B). Group A contained 202 cases (130 males and 70 females with an average age of 60.4±12.6) and Group B contained 196 cases (118 males and 78 females with an average age of 61.2±13.5). In Group A there were 157 cases (77.7%, Group A1) with normal serum creatinine (Scr) and 45 cases (22.3%, Group A2) with abnormal Scr before PCI. In Group B, the counterparts were 148 cases (75.5%, Group B1) and 48 cases (24.5%, Group B2). The levels of Scr were measured before and 72 hours after PCI.Results The levels of Scr did not change after PCI in Group A1 and Group B1, but increased statistically in Group A2 (P<0.05), despite an elevation not reaching statistical difference in Group B2 (P>0.05). Conclusion Using iso-osmolar contrast media may prevent from contrast-induced nephropathy.