CAJ | 학술논문

目的：探讨静脉-静脉血液滤过（CVVH）对伴有肾功能不全的不稳定型心绞痛（UAP）患者造影剂肾病（CIN）的预防作用。方法52例伴有肾功能不全的UAP患者，分为治疗组（26例）及对照组（26例），所有患者均接受择期经皮冠状动脉介入治疗（PCI）。治疗组于PCI术后立即给予CVVH ，对照组给予静脉水化治疗，比较2组患者CIN发生率、平均住院日及1年内进展至需要维持性血液透析患者比率。结果治疗组无CIN发生，对照组发生率达23％，2组比较差异有统计学意义（ P＜0.05）；治疗组平均住院日较对照组明显缩短[（7．1±1．2）d与（10．3±2．5）d]；1年内需要维持性透析患者比率治疗组为0，对照组为8％，差异无统计学意义（P＞0.05）。结论预防性CVVH对伴有肾功能不全的UAP患者因行PCI所致造影剂肾病的预防作用优于静脉水化治疗。
목적：탐토정맥-정맥혈액려과（CVVH）대반유신공능불전적불은정형심교통（UAP）환자조영제신병（CIN）적예방작용。방법52례반유신공능불전적UAP환자，분위치료조（26례）급대조조（26례），소유환자균접수택기경피관상동맥개입치료（PCI）。치료조우PCI술후립즉급여CVVH ，대조조급여정맥수화치료，비교2조환자CIN발생솔、평균주원일급1년내진전지수요유지성혈액투석환자비솔。결과치료조무CIN발생，대조조발생솔체23％，2조비교차이유통계학의의（ P＜0.05）；치료조평균주원일교대조조명현축단[（7．1±1．2）d여（10．3±2．5）d]；1년내수요유지성투석환자비솔치료조위0，대조조위8％，차이무통계학의의（P＞0.05）。결론예방성CVVH대반유신공능불전적UAP환자인행PCI소치조영제신병적예방작용우우정맥수화치료。
Objective To study the effect of continuous veno-venous hemofiltration(CVVH)on preventing contrast induced nephropathy (CIN) in unstable angina pectoris patients with renal dysfunction undergoing percu-taneous coronary intervention (PCI) .Methods Fifty-two UAP patients with renal dysfunction were randomly di-vided into treated group ( n = 26)and control group( n = 26) .All patients were given elective PCI .In treated group ,patients accepted CVVH after PCI immediately while control group patients received saline hydration .The main variable analyzed was the appearance of CIN and the secondary variables were the average length of stay and the development of clinical kidney failure .Results No CIN occurred in treated group and there was six in control group(23% ) ,which showed significant difference between two groups ( P< 0 .05) .The average length of stay of treated group was significantly shorter than that of control group ( P<0 .01) .During the first year ,there was no patient developed to clinical kidney failure in treated group and there were 2 patients in control group(8% ) ( P>0 .05) .Conclusion CVVH after PCI may be an effective strategy for the prevention of CIN in UAP patients with renal dysfunction .