不同粘度对比剂对冠状动脉造影患者肾功能的影响

Comparison of Different Viscosity Agent Effect on Renal Functions of Patients Undergoing Coronary Angiography

目的:对比剂肾病(CIN)是介入治疗中常见并发症之一。由于对比剂肾病发病机制复杂,其确切的机制尚不明确,有研究认为应用渗透压相似的对比剂,高粘度组对比剂引起CIN的几率明显高于低粘度组。本研究探讨接受不同粘度对比剂冠状动脉造影检查的患者术后引起肾功能损害的差异及其可能的机制。方法:80例接受冠状动脉造影检查的患者随机分为两组,分别为20℃碘海醇组、37℃碘海醇组,每组各40例。分别于冠脉造影前8h、冠脉造影后48 h采集同一患者肘正中静脉血进行血清肌酐(Scr)、血清胱抑素C(CysC)检测,并对数据进行统计学分析。结果:两组患者组间比较基本资料无明显差异,两组患者术后Scr、CysC较术前均升高,差异均有统计学意义(P<0.05);20℃碘海醇组术后Scr较37℃碘海醇组升高不明显,差异无统计学意义(P>0.05);20℃碘海醇组术后CysC较37℃碘海醇组升高明显,差异有统计学意义(P<0.05)。结论:冠脉造影检查时,对比剂对患者的肾功能有损害;选择低粘度对比剂可能减少其对冠状动脉造影患者的肾功能的不良影响;其作用机制可能与对比剂改变血液粘滞性,从而影响肾血流有关。

Objective： Contrast agent nephropathy （CIN） is one of common complications in interventional therapy. Due to the complexity of contrast medium kidney disease pathogenesis, the exact mechanism is unclear, a study that application of osmotic pressure similar to those of contrast medium and high viscosity group contrast medium caused CIN group significantly higher than the risk of low viscosity. Methods： 80 cases underwent coronary artery angiography were randomly divided into two groups 20 ℃ iohexol group and 37 ℃ iohexol group, 40 patients in each group. Before coronary angiography respectively 8 h, 48 h after coronary angiography to collect elbow in the middle of venous blood serum creatinine （Scr）, serum （chalone C （CysC） and the data statistical analysis. Results： Two groups of patients with no difference between the basic data is compared between groups. Two groups of patients with postoperative Scr, CysC is tied to elevated preoperative, difference have statistical significance （P 〈 0.05）; 20 ℃ sea iodine, alcohol group of Scr is 37 ℃ after iodine higher alcohol group is not obvious, there was no statistically significant difference （P 〉 0.05）; 20 ℃ sea iodine, alcohol alcohol CysC is 37 ℃ after iodine sea group increased significantly, the difference was statistically significant （P 〈 0.05）, Conclusion： Coronary angiography examination, contrast material on renal function in patients with damage; Choose low viscosity contrast agent could reduce its right of renal function in patients with coronary angiography;the mechanism may be related to changes in blood viscosity contrast agent, thus affecting the renal blood flow associated.