Paredes Oscar Luis, Shite Junya, Shinke Toshiro, Imuro Yusuke, Yoshikawa Ryouhei, Watanabe Satoshi, Ozawa Torn, Otake Hiromasa, Matsumoto Daisuke, Ogasawara Daisuke, Yokoyama Mitsuhiro
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe.
J Cardiol. 2005 Oct;46(4):161-4.
Among percutaneous coronary intervention post procedural complications, renal acute dysfunction due to administration of contrast agent is commonly seen in patients with pre-existing renal impairment, especially with co-existent diabetes mellitus and/or congestive heart failure. Although several strategies have been proposed to ameliorate this condition, their effects are inconsistent. A 66-year-old diabetic man at high risk for this complication underwent three distinct percutaneous coronary intervention procedures. Different strategies were used during each intervention to prevent the development of contrast medium-induced nephropathy. Dramatic renal protection was observed with human atrial natriuretic peptide administration or hemofiltration, whereas saline hydration had no apparent effect.
在经皮冠状动脉介入治疗术后并发症中,因使用造影剂导致的肾急性功能障碍在已有肾功能损害的患者中常见,尤其是合并糖尿病和/或充血性心力衰竭的患者。尽管已提出多种策略来改善这种情况,但其效果并不一致。一名66岁的糖尿病男性有发生这种并发症的高风险,他接受了三次不同的经皮冠状动脉介入治疗手术。在每次介入治疗期间采用了不同的策略来预防造影剂肾病的发生。观察到使用人心房利钠肽或血液滤过有显著的肾脏保护作用,而生理盐水水化则没有明显效果。