不同低渗非离子型造影剂剂量对冠脉介入治疗急性心肌梗死患者肾功能的影响

Effects of Different Dose of Low-permeability Non-ionic Contrast Agent on Renal Function in Patients with Acute Myocardial Infarction Undergoing PCI

目的:研究对行冠脉介入治疗的急性心肌梗死患者运用不同剂量的低渗非离子型造影剂后对肾功能的影响。方法:选取2017年2月-2019年2月于笔者所在医院行冠脉介入治疗的急性心肌梗死患者164例为研究对象,按随机数字表法分为低剂量组和高剂量组,每组82例。两组均选用碘佛醇为手术造影剂,其中低剂量组使用剂量<100 ml,高剂量组使用剂量为100~200 ml。比较两组介入术前后血清肌酐(Scr)、尿素氮(BUN)、内生肌酐清除率(Ccr)及血清胱抑素C(Cys C)等肾功能指标水平及术后并发症情况。结果:术后1 d,低剂量组Scr、BUN及Ccr水平均优于高剂量组(P<0.05);两组介入术前后Cys C比较,差异均无统计学意义(P>0.05);低剂量组并发症发生率低于高剂量组(P<0.05)。结论:低剂量低渗非离子型造影剂对冠脉介入治疗的急性心肌梗死患者肾功能影响较小,且并发症较少。

Objective:To study the effects of different dose of low-permeability non-ionic contrast agent on renal function in patients with acute myocardial infarction undergoing PCI.Method:From February 2017 to February 2019,164 patients with acute myocardial infarction who underwent PCI in our hospital were selected as the study objects,and they were divided into the low-dose group and the high-dose group according to the random number table,82 cases in each group.Ioversol was used as surgical contrast agent in the two groups.The dose of the low-dose group was less than 100 ml,and the high-dose group was 100-200 ml.The renal function indexes such as serum creatinine(Scr),blood urea nitrogen(BUN),creatinine clearance rate(Ccr)and serum cystatin C(Cys C)were compared between the two groups.Result:One day after the operation,the levels of Scr,BUN and Ccr in the low-dose group were better than those of the high-dose group(P<0.05).And the level of Cys C were compared between the two groups,and the difference was not statistically significant(P>0.05).The incidence of complications in the low-dose group was lower than that of the high-dose group(P<0.05).Conclusion:Low-dose low-permeability non-ionic contrast agent has little effect on renal function in patients with acute myocardial infarction undergoing PCI,and fewer complications.