王振伟,单安琪,李竹,康丽娜,王昆

• 1:南京大学医学院附属鼓楼医院心内科

摘要(Abstract)：

目的评估慢性肾病(CKD)3期和4期患者在行经皮冠状动脉介入治疗(PCI)后行床旁短时间血液滤过(血滤)对比剂肾病(CIN)的发生率以及临床疗效。方法回顾性分析2012年2月至2017年12月在南京大学医学院附属鼓楼医院心脏科因冠心病合并CKD 3期和4期需行PCI,且术后行床旁血滤的患者共78例。术后即刻开始床旁血滤,检测术前、术后第1天、第3天、第30天的血肌酐值,并根据Cockcroft和Gault equation公式计算肌酐清除率(CrCl)。以术后CIN的发生率作为主要观察指标,术后30 d主要严重不良临床事件(包括再发心绞痛、心肌梗死、心脏性猝死、缺血性和出血性卒中)作为次要观察指标。结果 78例患者平均年龄(73.31±1.54)岁,男性60例(76.9%),冠心病分型中稳定型心绞痛12例(15.4%),不稳定型心绞痛42例(53.8%),急性非ST段抬高型心肌梗死24例(30.8%),CKD 3期34例(43.6%),CKD 4期44例(56.4%);平均血滤持续时间(7.36±0.77)h,术前、术后第1天、第3天、第30天血肌酐值分别为(211.77±20.63)μmol/L、(165.18±10.50)μmol/L、(201.00±15.60)μmol/L、(212.65±24.10)μmol/L,Cr Cl分别为(32.62±2.09)ml/min、(40.96±2.06)ml/min、(34.48±2.12)ml/min、(32.26±2.08)ml/min,术后未出现CIN。随访第30天主要严重不良临床事件发生率为4例(5.1%)。结论术后尽早开始短时间血滤能够预防CKD 3期和4期患者CIN的发生,对于CIN高危患者,提供了一种可选择的预防CIN的措施。

关键词(KeyWords)： 血液滤过;慢性肾病;对比剂肾病

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王振伟,单安琪,李竹,康丽娜,王昆

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