不同剂量碘海醇对冠状动脉介入术患者肾功能的影响

摘要

目的 研究不同剂量的低渗性非离子型对比剂碘海醇对冠状动脉造影(CAG)和经皮冠状动脉介入治疗( PCI)患者肾功能的影响. 方法 选择我院2010年10月至2011年4月672例接受冠状动脉介入诊疗术的患者,根据对比剂用量分为2组:A组剂量＜ 200 ml,435例；B组剂量为200~ 400 ml,237例.以术后48 h血肌酐(SCr)较术前升高25％或升高44.2 μmol/L(0.5 mg/dl)作为对比剂肾病(CIN)的诊断标准,观察不同剂量碘海醇对肾功能的影响. 结果 672例患者中55例发生CIN,发生率为8.2％,其中A组26例(6.0％),B组29例(12.2％),2组间发生率有统计学差异(P＜0.05). 结论 对比剂碘海醇对冠状动脉介入诊疗术患者肾功能有影响,对比剂用量≥200 ml患者CIN发生率高.%Objective To investigate the influences of different dosages of Iohexol, a kind of low osmolar and nonionic contrast media, on renal function of patients undergoing percutaneous coronary intervention( PCI). Methods From October2010 to April 2011 ,a total of 672 patients undergoing CAG and PCI were recruited, and were divided into two groups according to different dosages of contrast media; group A containing 435 cases, the volume of contrast medium < 200 ml. group B containing 237 cases, the volume of contrast medium 200-400 ml. CIN was identified if the serum creati-nine was increased by 25% or 44. 2 μmol/L (0. 5 mg/dL) of the baseline 48 hours aften operation. The influences of different dosages of iohexol on renal function were analyzed. Results Among the 672 patients, CIN occurred in 55 patients and the incidence of CIN was 8. 2%. presented with CIN 26 patients in group A and the incidence was 6. 0% , compared with 29 patients and 12. 2% in group B. there was remarkable difference in the incidence of CIN between the two groups ( P < 0. 05). Conclusions Iohexo has effect on the renal function of patients undergoing PCI, and the incidence of CIN is higher in the patients receiving the volume of contrast medium ≥200 ml.