Zhu Ya-ting, Xiong Jiang, Guo Wei, Liu Xiao-ping, Yin Tai, Jia Xin, Ma Xiao-hui, DU Xin
The Vascular Surgery Department of the People's Liberation Army (PLA) General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2010 May 4;90(17):1155-8.
To compare the efficacies of different hydration strategies in protecting the renal function of the arteriosclerosis obliterans (ASO) patients undergoing endovascular treatments.
40 patients who underwent endovascular treatments for arteriosclerosis obliterans of lower extremities in the Vascular Surgery Department of PLA Hospital from January 2009 to October 2009 were divided into normal (serum creatinine < or = 110 micromol/L) and abnormal (serum creatine > 110 micromol/L) groups according to their baseline serum concentration of creatinine before treatments. Each group was treated by different hydration strategies 12 h before procedures. Changes of serum creatinine and creatinine clearance were measured 6, 24, 48 h after procedures to evaluate the changes of renal function and the effects of different hydration strategies.
No contrast-induced nephropathy (CIN) was observed among the 40 patients. There are significant differences between normal saline hydration group and control group in the changes of serum creatinine and creatinine clearance 24 h and 48 h after exposure to contrast medium for the normal renal function patients (P < 0.05). For the patients pre-existing renal dysfunction, no significant difference was found between Sodium Bicarbonate + Saline group and Saline group in the changes of Scr and Ccr 6, 24, 48 h after exposure to contrast medium (P > 0.05).
Sodium chloride provides a good efficacy for preventing the adverse effect of contrast medium to the renal function of the ASO patients. For the patients pre-existing renal dysfunction, Combination hydration with sodium bicarbonate is not more effective than normal saline alone in preventing contrast-induced renal dysfunction.
比较不同水化策略对接受血管腔内治疗的动脉硬化闭塞症（ASO）患者肾功能的保护效果。
选取2009年1月至2009年10月在解放军医院血管外科接受下肢动脉硬化闭塞症血管腔内治疗的40例患者，根据治疗前血清肌酐基线浓度分为正常（血清肌酐≤110μmol/L）和异常（血清肌酐＞110μmol/L）两组。每组在手术前12小时采用不同的水化策略进行治疗。分别于术后6、24、48小时测量血清肌酐和肌酐清除率的变化，以评估肾功能变化及不同水化策略的效果。
40例患者均未发生对比剂肾病（CIN）。对于肾功能正常的患者，生理盐水水化组与对照组在注射造影剂后24小时和48小时的血清肌酐和肌酐清除率变化方面存在显著差异（P＜0.05）。对于术前存在肾功能不全的患者，碳酸氢钠+生理盐水组与生理盐水组在注射造影剂后6、24、48小时的Scr和Ccr变化方面无显著差异（P＞0.05）。
氯化钠对预防造影剂对ASO患者肾功能的不良影响具有良好效果。对于术前存在肾功能不全的患者，碳酸氢钠联合水化在预防对比剂所致肾功能损害方面并不比单纯生理盐水更有效。
