不同类型对比剂对75岁以上老年人行冠脉介入术后肾功能的影响

发布时间：2018-04-19 22:18

本文选题：造影剂 + 造影剂肾病　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的比较使用低渗与等渗对比剂对接受行冠状动脉造影及介入治疗的75岁以上老年患者的肾脏功能的影响。方法回顾性分析2011年1月至2013年12月于厦门市心脏中心心血管内科住院行冠状动脉造影及介入治疗的75岁以上老年患者202例的资料，着重比较低渗与等渗对比剂对患者肾脏功能的影响。根据使用的造影剂类型不同，将患者分为A组(低渗造影剂组-LOCM，碘普罗胺)98例和B组(等渗造影剂组-IOCM，碘克沙醇)104例，，比较两组患者的临床特点、冠脉介入术前后血清肌酐(Scr)及估算肾小球滤过率（eGFR）变化、造影剂肾病(CIN)的发生率情况。结果两组患者在临床特点、手术前后血清肌酐水平、估算肾小球滤过率水平及估算肾小球滤过率差值的均值比较，差异均无统计学意义（P0.05）；使用两种不同类型造影剂均可能引起Scr的增高及eGFR的下降，导致CIN的发生，该202例患者中有5例发生CIN（总发生率为2.48％），其中A组4例，B组1例，低渗造影剂组的CIN发生率高于等渗造影剂组(4.08％VS0.96％)，但两组CIN发生率差异却无统计学意义（P0.05）。结论对于75岁以上老年人行冠脉介入手术时，使用低渗和等渗对比剂对术后短期肾功能的影响作用相当，尚不能认为等渗造影剂对肾功能的影响优于低渗造影剂。
[Abstract]:Objective to compare the effects of hypotonic and isosmotic contrast media on renal function in patients over 75 years of age undergoing coronary angiography and interventional therapy. Methods 202 patients over 75 years old who were hospitalized in Department of Cardiovascular Medicine of Xiamen Heart Center from January 2011 to December 2013 were analyzed retrospectively. The effects of hypotonic and isosmotic contrast agents on renal function were compared. According to the types of contrast agents used, the patients were divided into two groups: group A (hypotonic contrast agent group -LOCM), iopramide group (98 cases) and group B (isosmotic contrast agent group -IOCM-104 cases). The clinical characteristics of the two groups were compared. Before and after coronary intervention, the changes of serum creatinine (SCR), the estimation of glomerular filtration rate (GFR) and the incidence of contrast agent nephropathy (CINs) were observed. Results the clinical characteristics, serum creatinine level, estimated glomerular filtration rate and the mean value of the difference between the two groups were compared. The difference was not statistically significant (P 0.05), the increase of Scr and the decrease of eGFR might be caused by the use of two kinds of contrast agents, and the occurrence of CIN was found in 5 cases (the total incidence rate was 2.48%), and 1 case in group A (4 cases) and group B (1 case). The incidence of CIN in the hypotonic contrast group was higher than that in the isosmotic contrast medium group (4.08 vs 0.96), but there was no significant difference in the incidence of CIN between the two groups (P 0.05). Conclusion the effects of hypotonic contrast agent and isosmotic contrast agent on renal function in patients over 75 years of age after coronary intervention are equal, and the effect of isosmotic contrast agent on renal function is not superior to that of hypotonic contrast agent.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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