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不同水化方案预防造影剂肾病临床研究 被引量：22

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摘要 目的比较应用质量分数0.45%及0.9%氯化钠注射液、质量分数1.25%碳酸氢钠注射液3种水化治疗方案,预防伴肾功能不全急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(percutaneouscoronary intervention,PCI)术后造影剂肾病的效果。方法血肌酐>97μmol/L并行PCI术ACS患者300例随机分为A、B、C 3组各100例,分别应用质量分数0.45%、0.9%氯化钠注射液及质量分数1.25%碳酸氢钠注射液3种水化治疗方案,测定3组血肌酐、血尿酸及半胱氨酸蛋白酶抑制剂C水平,比较3组造影剂肾病(contrast induced nephropathy,CIN)发生率,Kaplan-Meier(K-M)生存曲线预测发生CIN对患者远期预后的影响。结果 A、B、C组术后48h血肌酐分别为(116.91±20.47)、(113.39±12.08)、(110.61±12.55)μmol/L,A组高于B、C组(P<0.05),B组与C组比较差异无统计学意义(P>0.05);A、B、C组CIN发生率分别为12%、4%、3%,3组比较差异有统计学意义(P<0.05);K-M生存曲线显示,PCI术后发生CIN者再次发生心绞痛或心肌梗死等终点事件的风险明显高于未发生CIN者(P<0.05)。结论伴有肾功能不全ACS患者行PCI术前、术后应用质量分数1.25%碳酸氢钠注射液进行水化治疗,可有效预防CIN发生,改善患者远期预后。
作者 唐勇 陈健 周卿 解玉泉 陈漫天 孟舒 沈成兴 张亚臣 李毅刚
机构地区 上海交通大学医学院附属新华医院心内科
出处 《中华实用诊断与治疗杂志》 2013年第8期783-785,共3页 Journal of Chinese Practical Diagnosis and Therapy
关键词 造影剂肾病 .肾功能不全 急性冠状动脉综合征 水化治疗
分类号 R692 [医药卫生—泌尿科学]
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参考文献10

  • 1Nash K,Hafeez A,Hou S.Hospital-acquired renal insufficiency[J].Am J Kidney Dis,2002,39(5):930-936.
  • 2Barrett B J,Parfrey P S.Preventing nephropathy induced bycontrast medium[J].N Engl J Med,2006,354(4):379-386.
  • 3Braunwald E,Antman E M,Beasley J W,et al.ACC/AHA2002 guideline update for the management of patients withunstable angina and non-ST-segment elevation myocardialinfarction-summary article:a report of the American College ofCardiology/American Heart Association task force on practiceguidelines(Committee on the Management of Patients withUnstable Angina)[J].J Am Coll Cardiol,2002,40(7):1366-1374.
  • 4National Kidney Foundation.K/DOQI clinical practiceguidelines for chronic kidney disease:evaluation,classification,and stratification[J].Am J Kidney Dis,2002,39(2 Suppl 1):S1-266.
  • 5Merten G J,Burgess W P,Gray L V,et al.Prevention ofcontrast induced nephropathy with sodium bicarbonate [ J].JAMA,2004,291(19):2328-2234.
  • 6王瑞强,王毅,蒲娟娟,刘闯,于洁,李涛.N-乙酰半胱氨酸对老年糖尿病患者造影剂肾病的预防作用[J].中华实用诊断与治疗杂志,2012,26(8):736-738. 被引量：4
  • 7Stevens M A,McCullough P A,Tobin K J,er al.A prospectiverandomized trial of prevention measures in patients at high riskfor contrast nephropathy:results of the P.R.I.N.C.E.Study.Prevention of radiocontrast induced nephropathy clinicalevaluation[J].J Am Coll Cardiol,1999,33(2):403-411.
  • 8Navaneethan S D,Singh S,Appasamy S,et al.Sodiumbicarbonate therapy for prevention of contrast-inducednephropathy ? a systematic review and meta-analysis [J].Am JKidney Dis,2009,53(4):617-627.
  • 9From A M,Bartholmai B J,Williams A W,et al.Sodiumbicarbonate is associated with an increased incidence of contrastnephropathy:a retrospective cohort study of 7977 patients atMayo Clinic[J].Clin J Am Soc Nephrol,2008,3(1):10-18.
  • 10Seeliger E,Becker K,Ladwig M,et al.Up to 50-fold increasein urine viscosity with iso-osmolar contrast media in the rat[J].Radiology,2010,256(2):406-414.

二级参考文献14

  • 1McCullough P A, Wolyn R, Rocher L L, et al. Acute renalfailure after coronary intervention: incidence, risk factors, and relationship to mortality[J]. Am J Med,1997,103(5) :368-375.
  • 2Toprak O. Risk markers for contrast-induced nephropathy[J]. Am J Med Sci,2007,334(4) :283-290.
  • 3Stolker J M, McCullough P A, Rao S, et al. Pre procedural glucose levels and the risk for contrast-induced acute kidney injury in patients undergoing coronary angiography[J]. J Am Coll Cardiol,2010,55(14) : 1433-1440.
  • 4Hardiek K J, Katholi R E, Robbs R S, et al. Renal effects of contrast media in diabetic patients undergoing diagnostic or interventional coronary angiography [ J 1. J Diabetes Complications,2008,22(3) :171-177.
  • 5Pflueger A, Abramowitz D, Calvin A D. Role of oxidative stress in contrast-induced acute kidney injury in diabetes mellitus[J]. Med Sci Monit,2009,15(6) :RA125-136.
  • 6Rudnick M R, Goldfarb S, Wexler L, et al. Nephrotoxicity of ionic and nonionie contrast media in 1196 patients: a randnmized trial. The Iohexol Cooperative Study[J]. Kidney Int, 1995,47 (1) :254-261.
  • 7Rudniek M R, Davidson C, Laskey W, et al. Nepb.rotoxicity of iodlxanol versus ioversol in patients with chronic kidney disease: the Visipaque Angiography/Interventions with Laboratory Outcomes in Renal Insufficiency (VALOR) Trial[J]. Am Heart J, 2008,156 (4) : 776-782.
  • 8Serafin Z, Karolkiewicz M, Gruszka M, etal. High incidence of nephropathy in neurosurgical patients after intra-arterial administration of low osmolar and iso-osmolar contrast media [J]. ActaRadiol,2011,52(4):422-429.
  • 9Rosenstock J L, Bruno R, Kim J K, et al. The effect of withdrawal of ACE inhibitors or angiotensin receptor blockers prior to coronary angiography on the incidence of contrast- induced nephropathy[J]. Int Urol Nephrol, 2008,40 (3) : 749- 755.
  • 10Chen S L, Zhang J, Yei F, etal. Clinical outcomes of contrast- induced nephropathy in patients undergoing percutaneous coronary intervention: a prospective, multicenter, randomized study to analyze the effect of hydration and acetylcysteine[J]. Int J Cardiol,2008,126(3) :407-413.

共引文献3

同被引文献248

  • 1杜小玉.水化疗法对预防介入手术后并发造影剂肾病的作用分析[J].医学信息（医学与计算机应用）,2014,0(14):474-474. 被引量：2
  • 2张庆娟（综述）,刘殿阁（审校）.造影剂肾病的防治进展[J].国际泌尿系统杂志,2007,27(1):117-120. 被引量：15
  • 3侯晓平,缪京莉,伦立德,郑晓勇,张婧.血液透析预防和救治老年造影剂相关肾病[J].中华老年多器官疾病杂志,2006,5(4):300-301. 被引量：3
  • 4苏海华.造影剂肾病的诊疗进展[J].国际移植及血液净化杂志,2006,4(3):1-4.
  • 5Jos H, Youn TJ, KH W , et al. Renal toxicity evaluation and comparison between visipaque ( lodixanol ) mad hexabrix ( loxaglate ) in patients with renal insufficiency undergoing coronary angiography: the RECOVER study: a randomized controlled trial[J].JACC, 2011, 48 (5): 924.
  • 6Sadeghi HM, Stone GW, Grines CL, et al. Impact of renal insuficiencyin patients undergoing primary angioplasty for acute myocardialinfarction[J]. Circulation, 2003,108(22): 2769-2775.
  • 7Sudarsky D, Nikolsky E. Contrast-induced nephropathy ininterventional cardiology [J]. Int J Nephrol Renovasc Dis, 2011, 7(4):85-99.
  • 8Marenzi G, De Metrio M, Rubino M, et al. Acute hyperglycemia andcontrast-induced nephropathy in primary percutaneous coronaryintery^ntion[J]. Am Heart J,2010, 160(6): 1170-1177.
  • 9Verzola D, Bertolotto MB, Villaqqio B, et al. Taurine preventsapoptosis induced by high ambient glucose in human tubule renalcells[J]. J Investig Med, 2002, 50(6): 443-451.
  • 10Alien DA, Harwood S, Varagunam M, et al. High glucose-inducedoxidative stress causes apoptosis in proximal tubular epithelial cellsand is mediated by multiple caspases [J]. FASEB J, 2003, 17(8):908-910.

引证文献22

二级引证文献141

中华实用诊断与治疗杂志
2013年 第8期

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