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目的观察低渗及等渗对比剂对心衰患者肾功能的影响。方法选择2007年1月～2009年12月于我院接受冠脉造影(CAG)和/或介入治疗(PCI)合并心功能纽约分级Ⅲ～Ⅳ级的患者128例,随机分为低渗组及等渗组。其中低渗组78例,等渗组50例,两组患者术前及术后72h均测定血清肌酐(Scr)及半胱胺酸蛋白酶抑制剂C(CysC)水平,计算对比剂肾病的发生率。结果两组术后Scr及CysC平均峰值水平较术前有所升高,其中低渗组Scr峰值平均升高11.2umol/L,CysC平均峰值增加0.12mg/L;等渗组Scr峰值平均升高10.6umol/L,CysC平均峰值增加0.11mg/L。低渗组对比剂肾病发病率为16.7%,等渗组对比剂肾病发病率为16.0%,二者比较无明显统计学差异(p>0.05)。结论低渗与等渗对比剂在心衰患者中对肾功能的影响无明显差异。
Objective To observe the effects of hypotonic and isotonic contrast media on renal function in patients with heart failure. Methods One hundred and eighty-eight patients with coronary heart disease who underwent coronary angiography (CAG) and / or interventional PCI in our hospital from January 2007 to December 2009 were randomly divided into two groups: hypotonic group Isotonic group. 78 cases in the hypotonic group and 50 cases in the isotonic group. Serum creatinine (Scr) and CysC (CysC) were measured before and 72 hours after operation in both groups, and the incidence of contrast-induced nephropathy . Results The average peak levels of Scr and CysC in both groups were higher than those before operation. The average value of Scr in hypotonic group was 11.2umol / L and the average peak value of CysC was 0.12mg / L, 10.6umol / L, the average peak CysC increased 0.11mg / L. The incidence of contrast nephropathy was 16.7% in the hypotonic group and 16.0% in the isotonic group. There was no significant difference between the two groups (p> 0.05). Conclusion There is no significant difference in the effects of hypotonic and isotonic contrast media on renal function in patients with heart failure.