冠心病心绞痛合并慢性肾病患者PCI术后序贯短期透析对肾功能的保护作用

且的：探讨冠心病心绞痛合并慢性肾病（CKD）的患者在介入治疗术后，采用序贯短期违析对于其肾功能的保护作用。方法：选取2013年7月至2016年7月期间于我院住院部接受诊治的68例冠心病心绞痛合并CKD患者作为研究对象，所有患者均行经皮冠状动脉介入治疗（PCI），采用随机分组法，将患者分为治疗组及对照组，对照组患者于PCI木前、术中、术后采用常规水化治疗，治疗组患者PCI术后在对照组治疗基础上增加序贯透析治疗，比较两组患者的治疗效果。结果：治疗组患者的血浆肌酐水平（1315±4．7μmol／L）明显抵于对照组（1572±5．6μmol／L）（P〈0．05），治疗组GFR（54．4±3．6ml／min）明显高于对照组（37．1±2．8ml／min）（P〈0．05）；治疗组患者PCI术后CIN发生率（5．88％）明显低于对照组（35．29％）（P〈0．05）。结论：冠心病心绞痛合并CKD进行PCI患者，术后应用序贯短期透析治疗，可减少对比剂对肾脏的损害，保护肾功能。

Objective ：To investigate the effects of sequential short-term dialysis for preventing contrast-induced nephropathy（CIN） for patients with angina pectoris of coronary heart disease and chronic kidney disease （CKD） undergoing percutaneous coronary intervention（PCI） .Methods： Between luly 2013 to July 2016, 68 cases of patients with angina pectoris of coronary heart disease and CKD underwent PCI in our hospital were randomly divided into treatment group and control group. The patients in the control group treated by volume expansion before PC1 , in PCI procedure and after PCI; The patients in the treatment group were treated by volume expansion ,besides,they were followed by sequential short-term dialysis after PCI, compared the effects of contrast media on renal function of two groups of patients. Results： The serum creatinine level in the treatment group were （131.5 ＋ 4.7 mol/L） significantly lower than the control group （157.2 ＋ 5.6 u mol/L） （P〈0.05）, the GFR of treatment group （54.4 ＋ 3.6 ml/min） was significantly higher than the control group （37.1 ＋ 2.8 ml/min） （P〈0.05）; The incidence rate of the CIN of the patients in the treatment group was significantly lower （5.88%） than the control group （3,5.29%） （P〈0.05）. Conclusion： Sequential short-term dialysis can prevente contrast-induced nephropathy for patients with angina pectoris of CHD and CKD undergoing PCI.