龙锋,张金霞,龚志华,文艳飞,曹志英,夏丽莎,李慧娣,李爱敏,向定成

• 1:第二军医大学广州临床医学院
• 2:广州军区广州总医院心血管内科

摘要(Abstract)：

目的比较等渗对比剂碘克沙醇与低渗对比剂碘海醇在急性ST段抬高型心肌梗死(STEMI)并行急诊经皮冠状动脉介入治疗(PCI)患者中对比剂致急性肾损伤(CI-AKI)的发生率。方法本研究为前瞻性、随机对照研究,连续入选2015年7月至2016年11月入住广州军区广州总医院胸痛中心并行急诊PCI的患者,根据心肌梗死病变部位区分下壁和前壁心肌梗死作为区组,分配至碘克沙醇组与碘海醇组,检测术后72 h内血清肌酸酐值。CI-AKI定义为:使用对比剂72 h内,血清肌酸酐值较基础值升高>25%或增加>0.5 mg/dl(44μmol/L)。结果 297例进入最终统计分析,碘克沙醇组与碘海醇组分别为149例和148例,其CI-AKI的发生率分别为22.1%和16.9%,按照非劣效界值Δ=10%计算,95%CI–14.2%~3.8%,P<0.002。同时前壁心肌梗死组与下壁心肌梗死组发生率为26.4%和11.6%,两组比较P=0.001,差异有统计学意义。结论在STEMI并行急诊PCI的患者中,低渗对比剂碘海醇非劣效于等渗对比剂碘克沙醇,在未来CI-AKI对比研究中按照心肌梗死病变部位进行分组可以尽可能地避免选择性偏倚。

关键词(KeyWords)： 对比剂致急性肾损伤;对比剂肾病;急性心肌梗死;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划专项(2016YPC1301201);; 广东省信息产业发展专项基金(粤经信[2014]975号);; 广州市科技计划项目(2014Y2-00068);广州市科技计划项目(201508020043)

作者(Author): 龙锋,张金霞,龚志华,文艳飞,曹志英,夏丽莎,李慧娣,李爱敏,向定成

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