低渗与等渗造影剂对不同分期慢性肾功能不全患者血肌酐水平的影响.docVIP

低渗与等渗造影剂对不同分期慢性肾功能不全患者血肌酐水平的影响 　　[摘要] 目的 比较低渗与等渗造影剂对不同分期慢性肾功能不全患者的血肌酐水平的影响。方法 整群选取并回顾性分析该院自2011年1月―2015年8月收治的91例肾功能不全患者在行计算机体层摄影（CT）增强扫描前后血肌酐清除率的变化，将91例患者按血清肌酐清除率分为CKD（慢性肾脏疾病）3期组、CKD4期组，各组按所使用造影剂的不同分为两个亚组。比较各亚组间肌酐（SCr）浓度升高值的差异。 结果 CKD4期组，低渗造影剂亚组在注射后第1天及第3天SCr浓度升高值分别为（10.6±15.2）μmol/L、（25.6±19.9）μmol/L，显著高于等渗造影剂亚组的（3.5±9.8）μmol/L和（17.3±10.6）μmol/L（t=4.613、3.762，P=0.012、0.015），第5天两亚组间差异无统计学意义（t=1.325，P=0.180）。CKD 3期患者各亚组间差异均无统计学意义（t=1.931、1.376、1.262，P=0.096、0.117、0.2680.05）。 结论 CD4期慢性肾功能不全患者，应用等渗性造影剂比低渗性造影剂更安全。 　　2.Luoyang Central Hospital Affiliated to Zhengzhou University，Luoyang，Henan Province，471009 China 　　[Abstract] Objective To compare the effect of low-osmolar and isosmolar contrast media on creatinine blood level？in patients with chronic renal insufficiency at different stages. Methods The changes of creatinine clearance rate of 91 cases of patients with chronic renal insufficiency admitted and treated in our hospital from January 2011 to August 2015 before and after computed tomography （CT） enhanced scanning were retrospectively analyzed， 91 cases of patients were divided into CKD3 group and CKD4 group according to the serum creatinine clearance rate， each group was divided into two subgroups according to the different uses of contrast media， the difference in the elevated value of the concentration of creatinine （SCr） between each subgroup wad compared. Results In the CKD4 group， the elevated values of the concentration of creatinine （SCr） on the first and the third day of injection in the low-osmolar contrast media subgroup were obviously higher than those in the high-osmolar contrast media subgroup， （10.6±15.2）μmol/L， （25.6±19.9）μmol/L vs （3.5±9.8）μmol/L， （17.3±10.6）μmol/L， （t=4.613、3.762，P=0.012、0.015）， the difference between the two subgroups on the fifth day was not statistically significant （t=1.325，P=0.180）， the differences between each group were not statistically significant in the CKD 3 group，（t=1.931、1.376、1.262，P=0.096、0.117、0.2680.05）.