水化治疗对老年患者冠状动脉介入诊疗术后肾功能的影响

摘要

目的：探讨在冠状动脉造影术和（或）介入术（以下简称CAG±PCI术）的术前预防性水化治疗对老年患者术后肾脏功能的影响。方法选择我院2010年12月～2013年6月所收治的150例接受CAG±PCI术的高龄患者（年龄≥75岁）的临床资料，随机分为水化组及对照组，其中水化组77例，对照组73例。所有患者均在术前、术后第3天、术后第5天进行检测血肌酐水平，观察两组患者术前术后血肌酐水平变化的情况。两组患者CAG±PCI术前血肌酐水平正常。两组患者CAG±PCI术前血肌酐水平以及肌酐清除率无明显差异（P＞0.05）。两组患者CAG±PCI术中造影剂用量无明显差异（P＞0.05）。结果水化组术后发生造影剂肾病（CIN）6例，发生率为7.79%；对照组术后发生造影剂肾病（CIN）17例，发生率为23.29%；水化组明显低于对照组，差异有统计学意义（P＜0.05）。结论老年冠心病行CAG±PCI术的患者是CIN的高危人群，水化治疗能够减少造影剂对肾脏的影响，保护肾脏功能，从而降低CIN的发生率。%ObjectiveTo investigate the effects on postoperative renal function in elderly patients with coronary angiography and / or intervention (hereinafter referred to as CAG±PCI patients) preoperative prophylactic hydration therapy.Methods 150 cases of elderly patients (age≥75 years) treated in our hospital from December 2010 to June 2013 150 received CAG±PCI surgery were randomLy divided into a hydration group and a control group, with 77 cases in the hydration group and 73 cases in the control group. The serum creatinine levels of all patients in the preoperative and postoperative first three days, postoperative the fifth days were detected, preoperative or postoperative serum creatinine levels of the two groups of patients were observed. The CAG±PCI preoperative serum creatinine levels of the two groups of patients were normal. The CAG±PCI preoperative serum creatinine levels and creatinine clearance between the two groups had no significant difference (P>0.05). The CAG±PCI intraoperative contrast agent of the two groups was no significant difference (P>0.05).Results It was happened 6 people with postoperative contrast-induced nephropathy (CIN) in the hydration group, with the rate 7.79%; there were 17 patients being contrast-induced nephropathy (CIN) , the rate was 23.29%; the hydration group was significantly lower than the control group, with statistical significance (P<0.05).Conclusion Elderly CAG±PCI postoperative with coronary heart is high risk of CIN, hydration therapy can reduce the impact of contrast agent on the kidneys, protect kidney function, thereby reducing the incidence of CIN.