静脉-静脉血液滤过对伴肾功能不全的不稳定型心绞痛患者造影剂肾病的预防作用

Effect of continuous veno-venous hemofiltration on preventing contrast induced nephropathy in patients with renal dysfunction

目的探讨静脉-静脉血液滤过(CVVH)对伴有肾功能不全的不稳定型心绞痛(UAP)患者造影剂肾病(CIN)的预防作用。方法 52例伴有肾功能不全的UAP患者,分为治疗组(26例)及对照组(26例),所有患者均接受择期经皮冠状动脉介入治疗(PCI)。治疗组于PCI术后立即给予CVVH,对照组给予静脉水化治疗,比较2组患者CIN发生率、平均住院日及1年内进展至需要维持性血液透析患者比率。结果治疗组无CIN发生,对照组发生率达23%,2组比较差异有统计学意义(P<0.05);治疗组平均住院日较对照组明显缩短[(7.1±1.2)d与(10.3±2.5)d];1年内需要维持性透析患者比率治疗组为0,对照组为8%,差异无统计学意义(P>0.05)。结论预防性CVVH对伴有肾功能不全的UAP患者因行PCI所致造影剂肾病的预防作用优于静脉水化治疗。

Objective To study the effect of continuous veno-venous hemofiltration（CVVH）on preventing contrast induced nephropathy （CIN） in unstable angina pectoris patients with renal dysfunction undergoing percu-taneous coronary intervention （PCI） .Methods Fifty-two UAP patients with renal dysfunction were randomly di-vided into treated group （ n = 26）and control group（ n = 26） .All patients were given elective PCI .In treated group ,patients accepted CVVH after PCI immediately while control group patients received saline hydration .The main variable analyzed was the appearance of CIN and the secondary variables were the average length of stay and the development of clinical kidney failure .Results No CIN occurred in treated group and there was six in control group（23% ） ,which showed significant difference between two groups （ P〈 0 .05） .The average length of stay of treated group was significantly shorter than that of control group （ P〈0 .01） .During the first year ,there was no patient developed to clinical kidney failure in treated group and there were 2 patients in control group（8% ） （ P〉0 .05） .Conclusion CVVH after PCI may be an effective strategy for the prevention of CIN in UAP patients with renal dysfunction .