口服水化下不同渗透压对比剂冠脉暴露后肾功能影响的研究

Study on the effect of different osmotic pressure contrast media on renal function after coronary exposure under oral hydration

目的观察口服水化条件下次高渗对比剂(LOCM)与等渗对比剂(IOCM)对冠脉对比剂暴露后的患者肾功能的影响。方法纳入2021年1月至12月冠脉对比剂暴露后的患者,常规口服水化治疗,随机分为LOCM组(使用LOCM碘佛醇,64例)和IOCM组(使用IOCM碘克沙醇,48例),比较术前、术后肾功能及对比剂致急性肾损伤(CIAKI)的发生情况。结果两组患者的一般情况无明显差异。两种对比剂均可引起Cys C与Scr增高及eGFR下降,差异有统计学意义(P<0.05);LOCM组波动高于IOCM组,但差异没有统计学意义(P>0.05)。两组共发生CI-AKI 5例(4.10%),其中LOCM组3例(4.69%),IOCM组2例(4.17%),差异无统计学意义(P>0.05)。结论常规给予口服水化下,使用LOCM与IOCM对冠脉术后短期肾功能的影响作用相当。

Objective To observe the effect of low-osmolar contrast media(LOCM)and iso-osmolar contrast media(IOCM)on renal function of patients after coronary artery contrast media exposure under the condition of oral hydration.Methods Patients were randomly divided into LOCM group(n=64)and IOCM group(n=48)after the exposure of coronary contrast agent from Janrary 2021 to December 2021.The occurrence of renal function and contrast agent-induced acute renal injury(CIAKI)were compared before and after operation.Results There was no significant difference between the two groups.Two kinds of contrast media can cause the increase of CysC and Scr,the decrease of eGFR,the difference was statistically significant(P<0.05).The fluctuation of renal function in LOCM group was higher than that in IOCM group,but the difference was not statistically significant(P>0.05).There were 5 cases(4.10%)of CI-AKI in the two groups,3 cases(4.69%)in LOCM group and 2 cases(4.17%)in IOCM group,the difference was not statistically significant(P>0.05).Conclusion The effects of LOCM and IOCM on short-term renal function after coronary artery operation were similar under the condition of routine oral hydration.