术后肌酐升高一例李为民课件.pptVIP

术后肌酐升高一例; 女，71岁 阵发性心前区疼痛3年，加重1周 高血压病15年 糖尿病史8年 心脏超声：左室舒张功能减低，EF：55% SCr： 96.3?mol/L ;CAG 2003-2-12;The First Affiliated Hospital of Harbin Medical University;TSUNAMI 3.0 x 25 mm;The First Affiliated Hospital of Harbin Medical University;;Def. Of CIN: 0.5 mg/dl or 25% increase Cr at 48 hours;;SCr;;;; But, occurs in 19.7% of patients with renal insufficiency + DM;RiskScore; 76岁 阵发性心前区疼痛加重10天 心脏超声：左室舒张功能减低，EF：47% SCr： 135.3?mol/L ;RiskScore;如何防治CIN;计算GFR（评估CIN风险）; 口服阿托乏他汀（20mg）;碱化尿液（NaHCO3) ; 选用非离子型、等渗造影剂 (威视派克);The First Affiliated Hospital of Harbin Med