胡文瑛,严鹏勇,王睿,王超凡,金惠根,刘宗军,汪志华

• 1:上海市普陀区中心医院心内科

摘要(Abstract)：

目的探讨重度肾功能不全患者行"零对比剂"经皮冠状动脉介入治疗(PCI)的安全性及有效性。方法对2018年1月至2019年12月上海市普陀区中心医院收治的16例重度肾功能不全[估算的肾小球滤过率(e GFR)<30 ml/(min·1.73 m~2)]的心绞痛或非ST段抬高型心肌梗死患者在血管内超声(IVUS)指导下行"零对比剂"PCI的临床资料进行回顾性分析。结果 16例重度肾功能不全患者的e GFR为(21.4±6.8)ml/(min·1.73 m~2),使用对比剂(25.0±3.8)ml以确定冠状动脉病变,于IVUS指导下行"零对比剂"PCI,术中支架定位确切,扩张满意,未出现夹层,最终所有患者心肌梗死溶栓治疗试验血流分级为Ⅲ级。16例重度肾功能不全患者PCI术后24 h e GFR、肌酐、肌红蛋白、肌酸激酶同工酶及心肌肌钙蛋白I与术前相比,差异均无统计学意义(均P>0.05);住院期间无再次心肌梗死、心绞痛等症状发生。3个月随访,无不良心血管事件发生。结论重度肾功能不全患者经IVUS指导行"零对比剂"PCI是安全有效的。

关键词(KeyWords)： 经皮冠状动脉介入治疗;对比剂肾病;重度肾功能不全;血管内超声

Abstract:

Keywords:

基金项目(Foundation): 上海市普陀区卫生健康系统临床医学优势学科（2019ysxk01）

作者(Author): 胡文瑛,严鹏勇,王睿,王超凡,金惠根,刘宗军,汪志华

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