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目的:探讨口服和静脉两种水化对冠状动脉介入(PCI)术后尿β2微球蛋白的影响,从而进一步探讨对比剂肾病(CIN)的发病机制。方法:选择CIN患者90例,随机分为口服水化组和静脉水化组,口服水化组术前6h到术后6h饮水1 500ml,静脉水化组术前6h到术后6h以1ml.kg-1.h-1速度给予0.9%氯化钠注射液静滴;测定术前,术后6、24、48和72h尿β2微球蛋白。结果:术前尿β2微球蛋白水平与术后48、72h的差别有统计学意义(P<0.05)。2组各时间点测尿β2微球蛋白水平差异无统计学意义。结论:尿β2微球蛋白在PCI术后48、72h升高,静脉水化较口服水化在CIN中未见优势。
Objective: To investigate the effects of oral and intravenous hydration on urinary β2-microglobulin in patients undergoing coronary artery intervention (PCI) to further explore the pathogenesis of contrast-induced nephropathy (CIN). Methods: Ninety patients with CIN were randomly divided into two groups: oral hydration group and intravenous hydration group. The oral hydration group received 1 500 ml of water 6 hours before operation to 6 hours after operation, and 1 ml between 6 hours before operation and 6 hours after operation. kg-1.h-1 0.9% sodium chloride injection rate of intravenous infusion; determination of preoperative and postoperative urinary β2 microglobulin 6,24,48 and 72h. Results: The preoperative urinary β2 microglobulin level was significantly different from postoperative 48 and 72h (P <0.05). There was no significant difference in urinary β2-microglobulin levels between two groups at each time point. CONCLUSION: Urinary β2-microglobulin increased at 48 and 72 h after PCI. Intravenous hydration had no advantage in CIN compared with oral hydration.