两种碘对比剂在冠脉造影应用中的有效性评价及其对患者肾功能的影响

Evaluation of the effectiveness of two iodine contrast agents in coronary angiography and its effect on renal function

目的比较国产和进口两种造影剂的有效性及其对患者肾功能的影响。方法将192例符合冠状动脉造影适应证的患者随机双盲分配在两种碘对比剂组中:其中试验组(R组)95例,使用进口碘普罗胺;对照组(T组)97例,使用国产碘海醇。分别评价两组患者的血管影像质量(以卫生部制定的X射线影片质量作为参照标准,把影像质量分为优、良、差三个等级);通过测量术前及术后72 h患者的肌酐、尿素氮以及尿酸水平的变化,分析两组碘对比剂诱导的急性肾损害(CIAKI)的发生情况。结果两组造影剂的血管影像质量无显著性差异;R组中尿素氮(P=0.0013)以及T组中尿素氮(P=0.026)、尿酸(P=0.0492)在造影术后的测定值与术前比有统计学差异,R组中有1例出现肌酐升高>基础值的25%,碘对比剂诱导的急性肾损害(CIAKI)发生率为1.05%,T组中无CIAKI发生。结论国产碘海醇冠状动脉造影过程中在血管影像质量方面与进口碘普罗胺一样有效,并且和进口碘普罗胺比较并不多引起CIAKI,可用于冠状动脉造影的临床需要。

Objective To compare the effectiveness of domestic and imported two contrast agents and theireffects on renal function in patients.Methods192patients with coronary angiography were randomly divided into twogroups:95patients in the R group(using iopromide)and97patients in the control group(T group,using iohexol).Theblood vessel image quality of the two groups of patients was evaluated(using the Ministry of Health X-ray film qualitystandard,divided into excellent,good,poor three grades).The changes of creatinine,urea nitrogen and uric acid levelswere measured before and72h after operation to compare the incidence of contrast-induced renal injury(CIAKI)induced by iodine contrast agents.Results There was no significant difference in vascular image quality between thetwo groups.The measured values of urea nitrogen(P=0.026)and uric acid(P=0.0492)in T group and urea nitrogen(P=0.0013)in R group were significantly different from those before operation.One patient in the R group showed a25%increase in creatinine,and CIAKI incidence was1.05%.No CIAKI has been found in the T group.ConclusionDomestic iohexol is as effective as imported iopromide in the process of coronary angiography image quality,and doesnot cause more CIAKI than iopromide,which can be used in coronary angiography.