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冠状动脉造影或血管成形术患者预防对比剂肾病的口服与静脉补液策略比较:一项随机临床试验

Comparison of oral and intravenous hydration strategies for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty: a randomized clinical trial.

作者信息

Kong De-Gui, Hou Yan-Fang, Ma Long-Le, Yao Dao-Kuo, Wang Le-Xin

机构信息

Department of Cardiology, Liaocheng People's Hospital of Taishan Medical University, Liaocheng, Shandong, P.R. China.

出版信息

Acta Cardiol. 2012 Oct;67(5):565-9. doi: 10.1080/ac.67.5.2174131.

Abstract

OBJECTIVE

The efficacy of oral hydration in the prevention of contrast-induced nephropathy in patients undergoing elective coronary intervention is unclear.

METHODS

A total of 120 patients were randomly assigned to three groups. Group A (n = 40) received intravenous hydration before and after coronary angiography or angioplasty. Group B (n = 40) received oral tap water before and after the procedures, whereas group C (n = 40) received only postprocedural drinking water. Levels of serum creatinine and urea nitrogen were measured before, 12 hours after, 2 and 3 days after the coronary angiography or angioplasty.

RESULTS

: There was no statistically significant difference in the age, sex, baseline renal function and the volume of contrast medium used during the coronary procedures among the three groups (P > 0.05).There was no statistically significant difference in the mean serum creatinine or urea nitrogen among the three groups 12 hours, and 3 days after the coronary procedures ( P > 0.05).The incidence of contrast-induced nephropathy in group A, B and C was 5.0% (2/40), 7.5% (3/40) and 5.0% (2/40), respectively (P = 0.86). Renal function in the seven patients who experienced contrast-induced nephropathy recovered within a week following rehydration treatment.

CONCLUSIONS

Pre- and post-procedural oral hydration was as effective as intravenous rehydration in the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty.

摘要

目的

口服补液对接受择期冠状动脉介入治疗患者预防造影剂肾病的疗效尚不清楚。

方法

总共120例患者被随机分为三组。A组(n = 40)在冠状动脉造影或血管成形术前及术后接受静脉补液。B组(n = 40)在操作前后饮用自来水,而C组(n = 40)仅在术后饮水。在冠状动脉造影或血管成形术前、术后12小时、2天和3天测量血清肌酐和尿素氮水平。

结果

三组患者的年龄、性别、基线肾功能以及冠状动脉操作期间使用的造影剂剂量无统计学显著差异(P > 0.05)。冠状动脉操作后12小时和3天,三组患者的平均血清肌酐或尿素氮无统计学显著差异(P > 0.05)。A组、B组和C组造影剂肾病的发生率分别为5.0%(2/40)、7.5%(3/40)和5.0%(2/40)(P = 0.86)。七例发生造影剂肾病患者的肾功能在补液治疗后一周内恢复。

结论

在接受冠状动脉造影或血管成形术的患者中,术前及术后口服补液在预防造影剂肾病方面与静脉补液同样有效。

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