非离子型与离子型对比剂不良反应及对肾功能指标影响观察

Study of Adverse Reactions of Non-ionic and Ionic Contrast and Their Influence on Renal Function Index

目的:观察比较非离子型与离子型对比剂的不良反应及对肾功能指标变化的影响。方法:180例在我院行介入影像检查的患者随机分为两组。非离子型组90例患者使用非离子型对比剂碘普罗胺注射液,离子型组90例使用离子型对比剂76%泛影葡胺注射液。比较两组患者造影前后肾功能指标变化,评价造影剂肾病(CIN)以及造影后不良反应发生情况。结果:非离子型组发生3例轻度不良反应,不良反应发生率4.44%;显著低于离子型组的12.22%(P<0.05)。造影后2 d,两组患者BUN、SCr均较造影前均明显升高(P<0.05),而Ccr则较前明显降低(P<0.05),且非离子型组上述指标均优于离子型组(P<0.05);两组CIN分别发生3例和4例,差异无统计学意义(P>0.05)。造影后7d,非离子型组SCr、BUN、Ccr与造影前比较无明显差异(P>0.05),离子型组SCr、BUN仍较造影前明显增高,Ccr则较前明显降低(P<0.05)。两组各项指标仍有明显差异(P<0.05)。结论:非离子型与离子型对比剂均会对患者肾功能产生一定影响,但非离子型对比剂影响较小,恢复更快;且不良反应发生较少,更为安全。

Objective： To compare of adverse effects of non-ionic and ionic contrast agents and their effects on renal function indexes. Methods： 180 patients with interventional imaging examination were randomly divided into two groups in our hospital. 90 patients in the nonionic group were administrated with non-ionic contrast agents and 90 patients in the ionic group with an ionic contrast agent,76% Meglumine Diatrizoate Injection. The renal function indexes were compared between the two groups before and after angiography. The CIN and adverse events were evaluated. Results： There were 3 cases of adverse reactions in the nonionic group,the rate was 4. 44%. It was significantly lower than that of ionic group,which was 12. 22%（P〈0. 05）. Compared with pre-angiography,SCr and BUN were significantly higher（P〈0. 05）,Ccr was significantly lower than that of post-angiography 2 days（P〈0. 05）. The index in the nonionic group was superior to the ionic group（P〈0. 05）. Compared with pre-angiography,the values of SCr,BUN and Ccr had no differences in nonionic group after 7 days angiography（P〈0. 05）. For the ionic group,the SCr and BUN were significantly higher than before and Ccr were lower than before（P〈0. 05）. There were obvious differences between the two groups（P〈0. 05）.There were 3 and 4 cases of CIN in each group,no statistical significance in the difference（P〈0. 05）. Conclusion： Nonionic and ionic contrast agents might resulted in damaging the kidney of the patients. However,the degree of damage of the non-ionic was slight,the recovery rate was faster. It had less adverse drug reaction and was safer.