摘要
目的观察水化治疗对使用非离子等渗对比剂的糖尿病肾病患者对比剂肾病的预防作用。方法 2007年1月至2010年12月本科收治的糖尿病肾病患者80例,其中男性30例,女性50例,年龄(64.4±9.3)岁,分为2组:①水化治疗组(n=39),在使用非离子等渗对比剂(碘克沙醇320 mg/ml)进行多检测器行列螺旋式计算机体层摄影(multidetec-tor-row helical computerized tomography,MDCT)检查前后12 h内予0.9%盐水以1 ml/(kg.h)的速度滴注进行水化,静脉补液量根据患者的体质量及患者心功能进行调整,要求患者24 h尿量达到2 L以上以达到充分水化。②常规治疗组(n=41),按患者正常治疗流程,不额外增加患者的饮水量及静脉液体输入量。记录和分析2组患者在检查前后48、72、168 h的血清肌酐浓度(SCr)变化情况。结果水化治疗组的血肌酐基础值为(160.9±62.7)μmol/L,给予非离子对比剂后48、72、168 h的血肌酐值分别为(145.8±78.7)、(143.1±47.6)、(153.8±59.8)μmol/L。水化治疗组的4次血肌酐值差异无统计学意义(P>0.05)。常规治疗组的血肌酐基础值为(180.3±91.4)μmol/L,给予非离子对比剂后48、72、168 h的血肌酐值分别为(185.5±71.3)、(188.7±104.3)、(188.3±90.6)μmol/L,常规治疗组给予对比剂前后的4次血肌酐值差异也无统计学意义(P>0.05)。但水化治疗组对比剂肾病发生率低于常规治疗组(P<0.05)。结论水化治疗可减少对比剂肾病的发生。
Objective To determine the prevention effect of hydration therapy on contrast-induced nephropathy（CIN） in diabetic nephropathy patients using non-ionic iso-osmolar contrast medium.Methods A total of 80 diabetic nephropathy patients（30 males and 50 females,mean age 64.4±9.3） who were admitted to our department from January 2007 to December 2010 were enrolled in this study.They were randomly divided into 2 groups,saline hydration group（n=39） and conventional therapy group.The patients of the former group received intravenous injection of 0.9% NaCl solution at a rate of 1 ml/（kg·h） for 12 h before and after contrast media administration for multidetector-row helical computerized tomography（MDCT）.The quantity of fluid was adjusted according to their body weight and cardiac function.Their urine volume within 24 h were required to be at least 2 liters to guarantee sufficient hydration.For the patients from the conventional therapy group,they received no additional water and fluid therapy.Patients of both group received an injection of non-ionic iso-osmolar contrast medium（iodixanol 320 mg/ml） before MDCT.Serum level of creatinine（SCr）were recorded and analyzed just before and 48,72,and 168 h after the administration.Results The baseline of SCr in saline hydration group was 160.9±62.7 μmol/L,and the level became 145.8±78.7,143.1±47.6 and 153.8±59.8 μmol/L,respectively in 48,72 and 168 h after the administration of non-ionic iso-osmolar contrast medium.There was no significant difference among them（P0.05）.The baseline of SCr in conventional therapy group was 180.3±91.4 μmol/L,and then the levels were 145.8±78.7,143.1±47.6 and 153.8±59.8 μmol/L,respectively in 48,72 and 168 h after the administration.The SCr showed no difference before and after administration in the conventional therapy group,either（P0.05）.However,the incidence of CIN was lower in the hydration group than that in conventional therapy group（P0.05）.Conclusion The incidence of CIN is lowered when saline hydration is used.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2011年第20期2184-2186,共3页
Journal of Third Military Medical University
关键词
糖尿病肾病
对比剂肾病
非离子等渗对比剂
水化治疗
diabetic nephropathies
contrast-induced nephropathy
non-ionic iso-osmolar contrast medium
saline hydration therapy
