肾阻力指数指导下的水化治疗预防造影剂肾病的临床研究

Clinical study on the prevention of contrast-induced nephropathy by hydration under the guidance of renal resistance index

目的:探讨冠心病合并慢性肾功能不全患者水化治疗的方案。方法:选择冠心病合并慢性肾功能不全拟行冠状动脉造影术的患者286例,随机分为标准水化组(143例,50%)和肾阻力指数指导下的水化组(143例,50%),观察围手术期心肾功能的主要指标变化及3个月主要不良事件发生率。结果:肾阻力指数指导下水化治疗组水化液体量高于对照组(P<0.05),造影剂肾病、血液透析、全因死亡的发生率低于对照组(P<0.05)。结论:肾阻力指数指导下的水化治疗能够有效减少冠心病合并慢性肾功能不全患者造影剂肾病的发生。

Objective:To explore the hydration treatment scheme of patients with coronary heart disease combined with chronic renal insufficiency.Method:Two hundred and eighty-six patients with combined coronary heart disease and chronic renal insufficiency were selected for coronary angiography. They were randomly divided into control group(143, 50%) and hydration group guided by renal resistance index(143,50%).We investigated the change of the main index of cardiac and renal function during perioperative period and the incidence of major adverse events in 3 months.Result:The number of hydration fluids was higher in the hydration treatment group under the guidance of renal resistance index than in the control group(P<0.05),and the incidence of contrast-induced nephropathy, hemodialysis and all-cause death was lower than that in the control group(P<0.05).Conclusion:Hydration treatment guided by renal resistance index can effectively reduce the incidence of contrast-induced nephropathy in patients with combined coronary heart disease and chronic renal insufficiency.