碘普罗胺联合水化治疗在预防糖尿病患者PCI术后对比剂肾病中的应用价值

The Application Value of Iopromide Combined with Hydration Therapy in Prevention of Contrast-induced Nephropathy in Patients with Diabetes after PCI

目的研究碘普罗胺联合水化治疗在预防糖尿病患者经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)中的应用价值。方法随机数表法将本院2017年5月~2019年1月诊治的98例糖尿病患者分为联合组与对照组,各49例,均于本院行PCI术,对照组给予常规治疗+碘普罗胺,联合组给予常规治疗+水化治疗+碘普罗胺。观察两组患者术前以及术后24h、72h肾功能指标、术后CIN发生率。结果两组患者治疗前血清肌酐(SCr)、尿微量白蛋白(mAlb)、胱抑素C(CysC)、肾小球滤过率(GFR)水平差异比较无统计学意义(P>0.05),术后24h、72hSCr、mAlb、CysC均有所升高,GFR水平有所降低,但联合组升高或降低的幅度明显低于对照组(P<0.05);联合组患者CIN以及不良反应发生率明显低于对照组(P<0.05)。结论碘普罗胺联合水化治疗可减轻糖尿病患者PCI术后肾功能损伤程度,减少术后CIN以及不良反应发生率。

Objective To study the application value of iopromide combined with hydration therapy in the prevention of contrastinduced nephropathy(CIN) in patients with diabetes after percutaneous coronary intervention(PCI). Methods 98 patients with diabetes who were diagnosed and treated in the hospital from May 2017 to January 2019 were divided into thecombined group and the control group by the random number table method, 49 cases in each group. All patients underwent PCI. The control group was given routine treatment and treatment with iopromide. The combined group was given conventional treatment, hydration therapy and treatment with iopromide. Renal function indexes before operation,at 24 h and 72 h after operation and the incidence of postoperative CIN in both groups were observed. Results There was no significant difference in serum creatinine(SCr), urine microalbumin(m Alb), cystatin C(CysC) or glomerular filtration rate(GFR) between the two groups before treatment(P>0.05). The levels of SCr, m Alb and CysC were increased butGFR was decreased at 24 h and 72 h after operation. The increase or decrease in the combined group was significantly smaller than that in the control group(P<0.05). The incidence rates of CIN and adverse reactions in the combined group were significantly lower than those in the control group(P<0.05). Conclusion Iopromide combined with hydration therapy can reduce the degree of renal function damage in patients with diabetes after PCI, and reduce the incidence of postoperative CIN and adverse reactions.