水化治疗对肾功能不全患者血尿酸水平的影响

Influence of hydration therapy to level of serum uric acid in patients with renal insufficiency

目的探讨水化治疗对轻度肾功能不全患者冠状动脉介入治疗后的血尿酸水平的影响。方法对拟行冠状动脉造影检查的患者,测定血尿酸、肌酐水平,根据患者血肌酐水平,分为肾功能正常组、肾功能轻度异常组。共入选348例患者,其中肾功能正常组295例,肾功能轻度异常组53例。所有入选患者均行冠状动脉造影,冠状动脉狭窄大于70%的患者行冠状动脉内支架植入术,对肾功能轻度异常组术前12h及术后24h行水化治疗,水化后复查血尿酸、肌酐水平。结果冠心病与非冠心病患者血尿酸水平比较,差异无统计学意义(P>0.05),肾功能轻度异常组手术前后血肌酐水平比较,差异无统计学意义(P>0.05),而肾功能轻度异常组术后血尿酸水平较术前下降,差异有统计学意义(P<0.05)。结论对肾功能轻度异常患者围术期行水化治疗,可安全耐受冠状动脉内介入治疗,水化治疗可能降低肾功能不全患者血尿酸水平。

Objective To investigate the influence of hydration therapy to the level of serum uric acid in the patients with mild renal insufficiency（MRI） who underwent percutaneous coronary intervention（PCI）. Methods The levels of serum uric acid and creatinine were tested in the patients undergoing coronary arteriography（CAG）. According to the level of serum creatinine, the pa- tients were divided into two groups., the MRI group（n~ 53） and the normal renal function group（control group, n = 295）. The pa- tients with coronary artery stenosis over 70% confirmed by CAG underwent PCI. The patients in the MRI group received hydration therapy at 12 h before procedure and at 24 h after CAG and PCL The serum uric acid and creatinine were tested again after hydra- tion. Results The differences of the serum levels of uric acid between the coronary artery disease（CAD） patients and the non-CAD patients were not significant（P^0.05） ,and the differences of the serum uric acid in the MRI group before and after the administra- tion of CAG and PCI were not significant（P〉0.05）. While the serum levels of uric acid in the MRI group were decreased after hy- dration,the difference was significant（P〈0.05）. Conclusion The patients with mild MRI can safely tolerate PCI if using hydration during perioperative period. Hydration can decrease the level of serum uric acid in the patients with MRI.