终末期肾病患者的冠状动脉介入治疗

Percutaneous coronary intervention for patients with end stage renal dysfunction

慢性肾病和终末期肾病发病率在世界范围内呈现上升趋势,并且合并冠心病和心肌梗死时易导致病死率增加。终末期肾病患者冠状动脉病变弥漫且多伴有严重钙化,行介入治疗预后较差,出血及血栓事件多见。因此冠状动脉介入治疗时应采用复杂病变简单处理的方法,充分评估出血和血栓风险,并采用肾脏保护措施以防止对比剂肾病的发生。

Incidence of chronic renal disease and end stage renal dysfunction was increased worldwide. When combined with end stage renal dysfunction,the patients with coronary artery disease had poor outcomes and high rate of cardiac death. Since diffused and calcified coronary artery lesion was more common in patients with end stage renal dysfunction,treatment only for severe lesion was recommend. Meanwhile, the risk of bleeding and thrombosis should be fully evaluated and regimen for renal protection should be applied to avoid contrast induced ncphropathy.