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目的探讨对于行冠脉造影/介入患者,应用生理盐水和碳酸氢钠两种不同干预方法后对比剂肾病(contrast-induced nephropathy,CIN)的发生率,验证并比较两种预防方法的有效性。方法将拟行冠脉造影/介入的患者210例,随机分为碳酸氢钠组(实验组,n=110例)和生理盐水组(对照组,n=100例)。两组分别给予1.25%碳酸氢钠注射液或0.9%氯化钠注射液,并测定造影前和造影后24h、48h的血清肌酐(Scr),比较两组患者CIN的发生率。结果两组患者共发生造影剂肾病17例(8.1%),其中碳酸氢钠组5例(4.5%),生理盐水组11例(12.0%),两组造影剂肾病的发生率具有显著性差异(P<0.05)。结论对于造影剂引发的急性肾损伤,在造影前采用碳酸氢钠进行水化预防比采用氯化钠水化预防更为有效。
Objective To investigate the incidence of contrast-induced nephropathy (CIN) after two different interventions of saline and sodium bicarbonate in patients undergoing coronary angiography / intervention and to verify and compare the effectiveness of the two preventive methods. Methods Totally 210 patients undergoing coronary angiography / intervention were randomly divided into sodium bicarbonate group (experimental group, n = 110) and saline group (n = 100). The two groups were given 1.25% sodium bicarbonate injection or 0.9% sodium chloride injection, and before and after angiography 24h, 48h serum creatinine (Scr), CIN in both groups were compared. Results There were 17 cases (8.1%) of contrast agent nephropathy in two groups, including 5 cases (4.5%) in sodium bicarbonate group and 11 cases (12.0%) in saline group. The incidence of contrast agent nephropathy was significantly different (P <0.05). Conclusions For contrast-induced acute kidney injury, sodium bicarbonate for hydration prevention prior to contrast is more effective than sodium chloride hydration prevention.