碘普罗胺对行冠状动脉介入术的急性冠状动脉综合征患者肾功能的影响

Effect of iopromide on renal function in patients with acute coronary syndrome undergoing percutancous coronary intervention

目的：研究低渗非离子型造影剂碘普罗胺对行冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者肾功能的影响。方法：158例接受PCI术的ACS患者分为2组：肾功能正常组（88例）和肾功能轻度异常组[70例,血清肌酐（SCr）水平120.45～232.05μmol/L]。测定2组患者PCI术前及术后24h、48h、7d的血尿素氮（BUN）、SCr水平。结果：肾功能正常组BUN水平在PCI术前与术后24h、48h、7d分别为（5.45±1.65）mmol/L、（5.60±1.58）mmol/L、（5.55±1.70）mmol/L及（5.48±1.81）mmol/L。PCI术前与术后BUN水平比较差异均无统计学意义（P〉0.05）。肾功能轻度异常组BUN水平在PCI术前与术后24h、48h、7d分别为（7.83±3.14）mmol/L、（8.43±3.37）mmol/L、（8.76±2.97）mmol/L及（8.11±3.18）mmol/L,PCI术前与术后BUN水平比较差异无统计学意义（P〉0.05）。肾功能正常组SCr水平PCI术前与术后24h、48h分别为（82.54±23.57）μmol/L、（85.48±22.47）μmol/L及（86.51±21.72）μmol/L;肾功能轻度异常组SCr水平PCI术前与术后24h、48h分别为（176.25±28.47）μmol/L、（181.71±25.54）μmol/L及（187.34±27.46）μmol/L。2组SCr水平在PCI术前术后比较差异均无统计学意义（P〉0.05）。肾功能均于PCI术后7d恢复至术前水平。结论：低渗非离子型造影剂碘普罗胺对接受PCI术的ACS患者的肾功能无明显影响。

Objective： To study the effects of the low-osmolality nonionic contrast media iopromide on renal function in patients with acute coronary syndrome （ACS） undergoing percutaneous coronary intervention （PCI）. Methods： One hundred and fifty-eight patients with ACS undergoing PCI were divided into two groups： the normal renal function group （88 cases） and the mild renal dysfunction group （70 cases, serum creatinine levels 120.45 - 232.5 μmol/L）. Blood urea nitrogen （BUN） and serum creatinine （SCr） levels were measured before PCI and 24 hours, 48 hours, and 7 days after PCI. Results： The BUN levels before PCI and 24 hours, 48 hours, and 7 days after PCI in the normal renal function group were （ 5.45 ± 1.65 ） mmol/L, （ 5.60 ±1.58 ） mmol/L, （5. 55 ±1.70）mmol/L, and （5.48 ± 1.81 ）mmol/L, respectively. There was no statistically significant difference in BUN levels before and after PCI （ P 〉 0. 05 ）. The BUN levels before PCI and 24 hours, 48 hours, and 7 days after PCI in the mild renal dysfunction group were （7.83 ± 3.14） mmol/L, （ 8.43 ± 3.37 ） mmol/L, （ 8.76 ± 2.97 ） mmol/L, and （ 8.11 ± 3.18 ） mmol/L, respectively; no statistically significant difference was observed in BUN levels before and after PCI （ P 〉 0.05 ）. The SCr levels before PCI and 24 hours and 48 hours after PCI in the normal renal function group were （ 82.54 ± 23.57 ） μmol/L, （ 85.48 ± 22.47 ）μmol/ L, and （86.51 ±21.72）μmol/L, respectively. The SCr levels before PCI and 24 hours and 48 hours after PCI in the mild renal dysfunction group were （ 176.25 ± 28.47 ） μmol/L, （ 181.71 ± 25.54 ）μmol/L, and （ 187.34 ± 27.46 ） μmol/L, respectively. The difference in SCr levels before and after PCI was not significant between both groups （ P 〉 0.05 ）. The renal function returned to the preoperative level 7 days after PCI. Conclusion： Low-osmolality nonionic contrast media iopromide has no marked effects on renal function in patients with ACS undergoing PCI.