中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2010年
3期
222-225
,共4页
刘同强%丁志坚%李娟娟%冯曦%张良峰%龚苏飞
劉同彊%丁誌堅%李娟娟%馮晞%張良峰%龔囌飛
류동강%정지견%리연연%풍희%장량봉%공소비
肾功能不全,急性%血液滤过%造影剂
腎功能不全,急性%血液濾過%造影劑
신공능불전,급성%혈액려과%조영제
Renal insufficiency,acute%Hemofiltration%Contrast media
目的 观察造影剂导致急性肾损伤老年患者早期应用连续性血液滤过(CVVHF)治疗的疗效.方法 将造影剂引起急性肾损伤老年患者36例,随机分为常规治疗组和CVVHF组,常规治疗组给予常规治疗,CVVHF组行冠状动脉造影后2.5 h立即予CVVHF治疗12 h;观察两组患者肾功能变化、需要暂时肾替代治疗的发生率、冠状动脉造影临床相关事件(肺水肿、心肌梗死、休克)发生率以及住院期间病死率.结果 常规治疗组造影剂肾病发生率为88.9%(16/18),CVVHF组为16.7%(3/18),差异有统计学意义(χ~2=18.836,P<0.01);常规治疗组需暂时肾替代治疗的发生率为72.2%(13/18),CVVHF组为11.1%(2/18),差异有统计学意义(χ~2=13.829,P<0.01);常规治疗组造影临床相关事件发生率为83.3%(15/18),CVVHF组为22.2%(4/18),差异有统计学意义(χ~2=13.486,P<0.01);常规治疗组住院病死率为16.7%(3/18),CVVHF组为5.6%(1/18),差异无统计学意义(χ~2=1.125,P>0.05).结论 早期应用CVVHF治疗老年患者冠状动脉造影后引起的急性肾损伤,可以有效地阻止造影剂对肾功能的损害,并可明显改善患者的预后.
目的 觀察造影劑導緻急性腎損傷老年患者早期應用連續性血液濾過(CVVHF)治療的療效.方法 將造影劑引起急性腎損傷老年患者36例,隨機分為常規治療組和CVVHF組,常規治療組給予常規治療,CVVHF組行冠狀動脈造影後2.5 h立即予CVVHF治療12 h;觀察兩組患者腎功能變化、需要暫時腎替代治療的髮生率、冠狀動脈造影臨床相關事件(肺水腫、心肌梗死、休剋)髮生率以及住院期間病死率.結果 常規治療組造影劑腎病髮生率為88.9%(16/18),CVVHF組為16.7%(3/18),差異有統計學意義(χ~2=18.836,P<0.01);常規治療組需暫時腎替代治療的髮生率為72.2%(13/18),CVVHF組為11.1%(2/18),差異有統計學意義(χ~2=13.829,P<0.01);常規治療組造影臨床相關事件髮生率為83.3%(15/18),CVVHF組為22.2%(4/18),差異有統計學意義(χ~2=13.486,P<0.01);常規治療組住院病死率為16.7%(3/18),CVVHF組為5.6%(1/18),差異無統計學意義(χ~2=1.125,P>0.05).結論 早期應用CVVHF治療老年患者冠狀動脈造影後引起的急性腎損傷,可以有效地阻止造影劑對腎功能的損害,併可明顯改善患者的預後.
목적 관찰조영제도치급성신손상노년환자조기응용련속성혈액려과(CVVHF)치료적료효.방법 장조영제인기급성신손상노년환자36례,수궤분위상규치료조화CVVHF조,상규치료조급여상규치료,CVVHF조행관상동맥조영후2.5 h립즉여CVVHF치료12 h;관찰량조환자신공능변화、수요잠시신체대치료적발생솔、관상동맥조영림상상관사건(폐수종、심기경사、휴극)발생솔이급주원기간병사솔.결과 상규치료조조영제신병발생솔위88.9%(16/18),CVVHF조위16.7%(3/18),차이유통계학의의(χ~2=18.836,P<0.01);상규치료조수잠시신체대치료적발생솔위72.2%(13/18),CVVHF조위11.1%(2/18),차이유통계학의의(χ~2=13.829,P<0.01);상규치료조조영림상상관사건발생솔위83.3%(15/18),CVVHF조위22.2%(4/18),차이유통계학의의(χ~2=13.486,P<0.01);상규치료조주원병사솔위16.7%(3/18),CVVHF조위5.6%(1/18),차이무통계학의의(χ~2=1.125,P>0.05).결론 조기응용CVVHF치료노년환자관상동맥조영후인기적급성신손상,가이유효지조지조영제대신공능적손해,병가명현개선환자적예후.
Objective To observe the efficacy of early application of continuous venovenous hemofiltration (CVVHF) in elderly patients with contrast-induced acute kidney injury (AKI) .Methods A total of 36 elderly inpatients with contrast-induced AKI were randomly divided into two groups:CVVHF group (n= 18) and routine treatment group (n = 18).The renal function, the incidences of contrast-induced nephropathy (CIN), in-hospital events (pulmonary edema, myocardial infarction and shock), temporary renal-replacement therapy and in-hospital mortality were observed.Results The incidence of CIN was higher in routine treatment group than in CVVHF group [88.9% (16/18) vs.16.7% (3/18), P<0.05].Temporary renal-replacement therapy was required in 13(72.2%) patients of routine treatment group and in 2(11.1%) patients of CVVHF group (P<0.05).The rate of in-hospital events was higher in routine treatment group than in CVVHF group [83.3%(15/18) vs.22.2% (4/18), P<0.01].In-hospital mortality rate was higher in routine treatment group than in CVVHF group [16.7%(3/18) vs.5.6%(1/18), P>0.05].Conclusions Early application of CVVHF in patients with contrast-induced AKI after percutaneous coronary intervention appears to be effective in preventing the deterioration of renal function, and it could improve in-hospital outcomes.
