Clinical Research Of Three Hydration Treatments After PCI For Patients With Coronary Heart Disease Complicated By Different Levels Of Renal Function

Objective To investigate the efficacy of three protective measures of kidney function(hydration treatment)during perioperative period of interventional therapy for renal function of gerontic patients with percutaneous coronary intervention(PCI) complicated by different levels of renal function.Methods The relation between three hydration therapies and renal function of187PCI patients were analyzed. including93cases with endogenous creatinine clearance quartile90ml/min and94cases with endogenous creatinine clearance rate60-90ml/min. These patients were divided into three groups according to the level of renal function:in the group A,patients were treated with the hydration treatment of normal0.9%sodium chloride solution during interventional perioperative period(IPP); in the group B, patients were treated with the hydration treatment of normal0.9%sodium chloride solution plus small doses of dopamine during IPP; in the group C, patients were treated with hydration treatment of normal0.9%sodium chloride solution plus low dose NaHCO3during IPP.Blood BUN. Blood Cr, and β2-Valbuminuria levels of all patients were measured before and after PCI. And endogenous creatinine clearance rate(Ccr) was calculated.Results21cases got contrast-induced nephropathy in187patients, including2cases of preoperative normal renal function,19cases of preoperative abnormal renal function. The results in the same group of the same level of kidney function showed: the time point is at the postoperative48h that the postoperative serum creatinine value is statistically significant (P <0.05) in three groups. The postoperative endogenous creatinine clearance decreased statistically at the postoperative48h in the patients of preoperative normal renal function, and at the postoperative24h.48h and72h in the patients of preoperative abnormal renal function. Urine β2-Valbuminuria of all patients increased significantly at the postoperative24h,48h and72h. the time point of Blood BUN was no significant difference in statistics. After48h postoperation, serum creatinine increased significantly in the same level patients of preoperative renal function. Compared with the other groups.the rise of group C is the minimum. The group B and C was no significant difference in statistics(P>0.05).the more of A and B two groups of significant difference statistically (P<0.05). After48h and72h postoperation, endogenous creatinine clearance rate decreased in the patients of preoperative normal renal function. After24h,48h and72h postoperation, endogenous creatinine clearance rate of three groups in preoperative abnormal renal function have significant difference in statistics(P<0.05). The reduction of group C is the minimum. The results of multiple comparison:BC, AC has statistically significant differences:the group A and B has statistically no significant differences (P>0.05). After24h.48h and72h postoperation. urine β2-albuminuria increased significantly in all patients. The rise of group C is the minimum. The results of multiple comparison:BC, AC and AB has statistically significant differences (P<0.05). Blood BUN was no significant difference in statistics (P>0.05) in all groups.Conclusion The part of patients with normal serum creatinine is check out abnormal renal function. In preoperative endogenous creatinine clearance rate should be calculated regularly. Renal damage associated Contrast medium can be prevented by strengthening the hydration treatment in clinic. Compared with the hydration treatment of0.9%sodium chloride solution and the0.9%sodium chloride solution plus small doses of dopamine hydration treatment of0.9%sodium chloride solution plus low dose NaHCO is more significant, especially for the patients with abnormal serum creatinine.