CAJ | 학술논문

目的：研究不同类型造影剂及是否采用水化治疗对老年冠状动脉造影患者肾功能的影响。方法2010年9月到2011年2月我院心内科住院的疑似冠心病并行冠状动脉造影术的老年患者120例,根据使用造影剂的不同随机分为低渗组(n=60)和等渗组(n=60)。低渗组使用碘海醇,等渗组使用碘克沙醇；在造影前后根据是否水化治疗又分为水化组(n=30)和对照组(n=30),观察不同类型造影剂及水化治疗在使用造影剂后3d、7d的患者肾小球虑过率(GFR)的变化。结果与术前比较,造影后3天,患者GFR下降( P<0．05),7天基本恢复正常,但是在等渗和低渗组二者没有差异(P>0．05)；无论在等渗或低渗组,水化治疗组均较对照组的GFR下降有减轻(P<0．05)。结论在肾功能正常的老年患者,为预防造影剂肾病,水化治疗可能较昂贵的等渗造影剂更有效。
목적：연구불동류형조영제급시부채용수화치료대노년관상동맥조영환자신공능적영향。방법2010년9월도2011년2월아원심내과주원적의사관심병병행관상동맥조영술적노년환자120례,근거사용조영제적불동수궤분위저삼조(n=60)화등삼조(n=60)。저삼조사용전해순,등삼조사용전극사순；재조영전후근거시부수화치료우분위수화조(n=30)화대조조(n=30),관찰불동류형조영제급수화치료재사용조영제후3d、7d적환자신소구필과솔(GFR)적변화。결과여술전비교,조영후3천,환자GFR하강( P<0．05),7천기본회복정상,단시재등삼화저삼조이자몰유차이(P>0．05)；무론재등삼혹저삼조,수화치료조균교대조조적GFR하강유감경(P<0．05)。결론재신공능정상적노년환자,위예방조영제신병,수화치료가능교앙귀적등삼조영제경유효。
Objective To investigate the effect of different kinds of contrast media and hydration therapy on renal function in the aged patients after coronary angiography. Methods 120 aged inpatients suspected coronary heart diseases undergoing coro-nary angiography were observed from Sep 2010 to Feb 2011,they were divided randomly into two groups according to the different kinds of contrast media. the isotonic pressure group with zodixanol(n=60)and the hypotonic pressure group with omnlpague(n=60). then they were divided into two groups according to whether received hydration therapy after coronary angiography. the hydra-tion therapy group(n=30)and the control group(n=30). the difference of glomerular filtration rate(GFR)in the third days and the seventh day were observed after coronary angiography in the different group. Results Compared to the preoperative, the GFR of the patients declined after 3 days of angiography ( P <0. 05 ) and then recovered next to normal after 7 days of angiography ( P >0. 05),but there was no difference in the isotonic pressure group and the hypotonic pressure group(P>0. 05). hydration treatment therapy can alleviate the damage of GFR no matter in the isotonic or hypotonic pressure group (P<0. 05). Conclusion Hydration therapy may be more effective than selecting the expensive contrast media in prevention contrast induced nephrop-athy in aged patients with normal renal function.