两种不同水化方式对预防老年冠脉血管造影剂肾病的探讨

Investigation of the prevention of two different ways of hydration to aged contrast induced nephropathy after coronary angiography

目的:探讨两种不同水化方式对预防老年冠脉血管造影剂肾病(CIN)的影响。方法:选取300例行冠脉血管造影术的老年患者,随机平均分为试验组和对照组,每组150例。试验组术前10 h给予静脉滴注生理盐水,速度为1 ml/(kg·h),术后2 h内口服1 000 ml水,同时术后10 h继续静脉滴注生理盐水,速度同术前;对照组术前常规补液,术后给予500 ml生理盐水静脉滴注,时间<6 h。观察两组患者术前、术后48 h及72 h的血肌酐、胱抑素C水平。结果:冠脉造影术水化前试验组和对照组血肌酐及胱抑素C水平差异无统计学意义(P>0.05),试验组术后48 h及72 h血肌酐、胱抑素C水平较对照组显著性降低,差异有统计学意义(P<0.05)。结论:试验组水化方式能更好地保护肾功能,从而减少老年冠脉血管CIN的发生,值得推广。

Objective To investigate the prevention of two different ways of hydration to aged contrast induced nephropathy after coronary angiography. Method 300 cases undergoing coronary angiography in elderly patients were randomly divided into experimental group and control group,150 cases in each group. The experimental group got intravenous infusion of normal saline at a speed of 1 ml /（ kg·h）,10 hours before coronary angiography. in addition,1 000 ml water was drinked within 2 h by the experimental group. The control group only received conventional hydration before coronary angiography and normal saline 500 ml in less than 6 hours after it. We observed serum creatinine,cystatin C levels of the two groups before and 48 and 72 hours after coronary angiography. Results Serum creatinine and cystatin C levels were not statistically significant before coronary angiography between the experiment group and the control group（ P〈0. 05）,but they were significantly lower in the experimental group than that of the control group both 48 and 72 hours after coronary angiography（ P〈0. 05）. Conclusion The way of hydration in the experimental group is better for renal function,so it can reduce contrast induced nephropathy,worthy of promotion.