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造影剂温度对经皮冠状动脉介入治疗患者造影剂肾病发病率的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第2期
页码:
198-201,205
栏目:
临床研究
出版日期:
2016-11-25

文章信息/Info

Title:
Effects of contrast temperature on prevalence of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention
作者:
王心镜1; 刘平玲2; 曹 雪1; 王 辛1; 才振国1; 夏洪远1; 李学奇1
（1.哈尔滨医科大学附属第四医院心内科，黑龙江 哈尔滨 150001；
2.德州市陵城区人民医院小儿科，山东 德州 253500）
Author(s):
WANG Xin-jing1;  LIU Ping-ling2;  CAO Xue1;  WANG Xin1;  CAI Zhen-guo1;  XIA Hong-yuan1;  LI Xue-qi1
(1.Department of Cardiology, Fourth Affiliated Hospital, Harbin Medical University, Harbin 150001, Heilongjiang, China；
2.Department of Pediatrics, Lingcheng People’s Hospital, Dezhou 253500, Shandong, China)
关键词:
经皮冠状动脉介入治疗; 造影剂肾病; 碘克沙醇; 黏度; 温度; 血液流变学
Keywords:
percutaneous coronary internvention;  contrast-induced nephropathy;  iodixanol;  viscosity;  temperature;  hemorheology
分类号:
R541.4；R692
DOI:
-
文献标识码:
A
摘要:
目的 探讨造影剂温度对造影剂肾病（CIN）发病率的影响。方法 将157例经皮冠状动脉介入（PCI）治疗患者随机分为20℃碘克沙醇组（20℃组，n=77）和37℃碘克沙醇组（37℃组，n=80）。 分别于PCI术前、后行血液流变学指标检测；PCI术前24 h内、术后12、24 和48 h检测血浆胱抑素C和肌酐。分析两种温度造影剂对患者肾功能和血液流变学指标的影响。结果 20℃组PCI术后24 h的胱抑素C、48 h的肌酐显著高于术前(P<0.05)，全血高切、低切表观黏度亦显著较术前升高，差异有统计学意义（P<0.05）。 37℃组PCI术后24 h的胱抑素C、48 h的肌酐低于20℃组相应时间点水平，且PCI术后全血高切、低切表观黏度亦低于术后20℃组，具有统计学意义（P<0.05）。37℃组CIN发生率（2%）显著低于20℃组（8%），具有统计学意义（P<0.05）。结论 37℃碘克沙醇的CIN发生率显著低于20℃碘克沙醇。
Abstract:
AIM To investigate the effects of contrast temperature on the prevalence of contrast-induced nephropathy (CIN). METHODS A total of 157 patients who underwent percutaneous coronary intervention were randomly divided into 20℃ iodixanol group (n=77) and 37℃ iodixanol group (n=80). Hemorheology indexes were determined prior and post-index procedure, respectively. Meanwhile, serum cystatin C and creatinine were also detected within 24 h prior to index procedure and at 12, 24, and 48 h post-index procedure, respectively. The effects of two types of contrast temperature on renal function and hemorheology indexes were analyzed. RESULTS Serum cystatin C at 24 h post-procedure and creatinine at 48 h post-procedure were higher than pre-procedure in 20℃ iodixanol group, which were both statistically significant (P<0.05). Compared to pre-procedure, both high and low shear rate blood viscosity post-procedure were statistically significantly increased in 20℃ iodixanol group. Serum cystatin C at 24 h post-procedure and creatinine at 48 h post-procedure in 37℃ group were significantly lower than in the 20℃ group, respectively (P<0.05). Compared to the 20℃ group post-procedure, both high and low shear rate blood viscosity post-procedure were statistically significantly lower in 37℃ iodixanol group (P<0.05). The prevalence of CIN in 37℃ iodixanol group was statistically significantly lower than in the 20℃ iodixanol group (2% vs. 8%, P<0.05). CONCLUSION The prevalence of CIN in the 37℃ iodixanol group is significantly lower than in the 20℃ iodixanol group.

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备注/Memo

备注/Memo:
收稿日期：2016-01-22.
通讯作者：夏洪远，副主任医师，主要从事冠状动脉介入和心脏起搏研究 Email：xhy197112@sina.com
作者简介：王心镜，住院医师，硕士 Email：wcy_581@163.com
更新日期/Last Update: 2016-10-11