水化联合腺苷受体抑制剂对造影剂肾病的预防作用

HYDRATION COMBINED WITH ADENOSINE RECEPTOR INHIBITORS FOR PREVENTION OF CONTRAST-INDUCED NEPHROPATHY

目的探讨介入检查和治疗过程中水化联合腺苷受体抑制剂对造影剂肾病的预防作用。方法选择我院2010年10月—2013年10月于导管室行冠状动脉造影(CAG)和/或经皮冠状动脉介入治疗(PCI)患者共258例,随机分为水化联合腺苷受体抑制剂研究组和水化治疗对照组,其中研究组102例,对照组156例。术前查血清肌酐水平,并依据Cockcroft-Gault公式计算血清肌酐清除率;术后检测所有患者第二天、第三天血清肌酐水平,计算血清肌酐清除率。结果研究组与对照组在应用造影剂前后血清肌酐水平、血清肌酐清除率的变化程度不同,与研究组相比,对照组血清肌酐水平升高的程度、血清肌酐清除率下降的程度更明显(P<0.05)。研究组造影剂肾病的发生率为4.9%,对照组造影剂肾病的发生率为11.5%,差异有统计学意义(P<0.05)。结论本研究通过比较研究组和对照组术前和术后血清肌酐水平、血清肌酐清除率的变化,二组造影剂肾病的发生率等资料,表明在充分水化的基础上联合腺苷受体抑制剂能够降低造影剂肾病的发生率,对造影剂肾病的发生有一定的预防保护作用。

Objective To Investigate the process of Intervention examination and treatment of hydration combined adenosine receptor inhibitors on the prevention of contrast - induced nephropathy. Method Choose our department in October 2010 to October 2013 in the cath lab for coronary angiography （ CAG） and （or） percutaneous coronary intervention （PCI） 258 patients were randomly assigned to adenosine by the hydration of the joint inhibitor treatment of study group and control group hydration, which research group in 102 cases, the control group of 156 cases. Check the level of preoperative serum creatinine, and calculated according to Cockcroft- Gault serum creatinine clearance; detect all patients after the Second days, Third days in serum creatinine levels, calculated serum creatinine clearance. Result Study group and control group after using contrast agent in the application of serum creatinine, serum creatinine clearance rate of change in varying degrees, compared with the study group and control group with elevated levels of serum creatinine level, serum level of creatinine clearance decline more significantly （ P〈0.05 ）. Study group the incidence of contrast - induced nephropathy was 4.9 % in the control group, the incidence of contrast - induced nephropathy was 11.5%, was statistically significant （P〈0.05）. Conclusion In this study, by comparing the study group and control group preoperative and postoperative serum creatinine levels, serum creatinine clearance rate of change, two groups of the incidence of contrast- induced nephropathy and other information, that the full hydration of the inhibition of adenosine receptors on the basis of joint agents can reduce the incidence of contrast- induced nephropathy, the incidence of contrast- induced ne- phropathy have preventive protection.