摘要
目的造影剂肾病(Contrast media induced nephropathy,CIN)是发生于对比剂(CM)应用之后的急性肾功能损害,大约占所有获得性肾功能不全的11%。本研究目的在于观察茶碱药物是否可以减少CIN。方法 280例接受造影剂患者随机分成碳酸氢钠加氨茶碱组(n=152)和仅用碳酸氢钠组(n=128)。分别于造影剂应用前后测验血尿素氮、肌酐、肾小球滤过率(GFR)。两组患者的临床特征和造影剂应用剂量相似。结果符合CIN者14例,其中6例男性。CIN患者的平均年龄(58.64±8.96)岁,9例患者血肌酐≥1.5 mg/dl。CIN患者的造影剂用量为(196.4±116.8)ml。与非CIN(4.55±3.9)患者相比,CIN患者危险计分较高(12.00±2.90)。茶碱药物组患者CIN发生率明显低于仅用碳酸氢钠组(1.6%比7.9%;P=0.015)。茶碱组仅有2例CIN,对照组有10例,差异有统计学意义(P=0.015)。茶碱组有1例、对照组有2例出现少尿。根据CIN危险计分,低危险患者应用茶碱后CIN发生率无显著下降,中至重度危险者CIN发生率显著降低(P=0.014)。结论茶碱可以减少CIN的发生率。
Objective The contrast media induced nephropathy（ contrast media induced nephropathy, CIN） is an acute renal damage after the application of contrast agent （CM） , accounts for approximately 11% in all acquired renal insufficiency. The pur- pose of this study was to observe the effect of theophylline on preventing contrast medium-induced nephropathy. Methods All 280 cases with contrast agent were randomly divided into two groups,one group was given with sodium bicarbonate plus Amin- ophyline（ n = 152） and another only with sodium bicarbonate（ n = 128 ）. The level of blood urea nitrogen and creatinine, glomeru- lar filtration rate（GFR） were tested before and after the application of contrast agent, The clinical features and contrast agent do- ses were approximate in both groups. Results There were 14 patients with CIN and 6 cases were male. The average age of the patients with CIN was（58.64 ± 8.96） and serum ereatinine levels of 9 patients were higher than 1.5 mg/dl. The amount of con- trast agent for patients with CIN was（ 196.4 ± 116.8） ml. The risk score in patients with CIN was higher（ 12.00 ± 2.90） than that in patients without CIN （4.55 ± 3.9）. The incidence of CIN in theophylline group was significantly lower than that in control group（ 1,6% vs. 7.9% ;P=0. 015 ）. Two cases were found to be CIN in theophylline group and 10 cases in control group, the difference was statistically significant（P = 0. 015 ）. One cases in the theophylline group and 2 cases in control group appeared the symptom of oliguria. For the lower risk patients,theophylline did not significantly decreased the incidence of CIN, but for moderate and severe risk patients theophylline did obviously decreased the incidence of CIN（P = 0.014）. The incidence of CIN was signifi- cantly lower in theophylline plus sodium bicarbonate group as compared to the sodium bicarbonate group（ 1.6% vs. 7.9% ;P = 0.015）. Conclusion Theophylline can reduce the incidence of CIN.
出处
《中华全科医学》
2012年第11期1717-1718,1738,共3页
Chinese Journal of General Practice
关键词
造影剂肾病
茶碱
碳酸氢钠
Contrast-induced nephropathy
Theophylline
Sodium bicarbonate
