A Study On The Effects Of Low-osmolar And Nonionic Contrast Media On Renal Functions

Objective:According to a study published in the American Heart Association 《Circulation: Cardiovascular Quality and results》,showed to2030, due to aging、smoking、 hypertension and other risk factors, the morbidity and mortality of cardiovascular diseases (CVD) in China will rise sharply.Which is just from2010to2030of the aging and population growth, the incidence of cardiovascular disease in our country will grow by more than50%, estimated blood pressure, cholesterol and diabetes increasing may lead to cardiac events increased by additional23%, that is to say these percentages together may be equivalent21,300,000CVD events and7,700,000related deaths from2010to2030, in which account for the largest proportion of the coronary heart disease (CHD). With the increasing incidence of coronary heart disease and the rapidly development of interventional cardiology, angiography and coronary interventional operation increase rapidly, followed by the events of postoperative contrast-induced nephropathy is rapidly increasing. Contrast induced nephropathy (contrast-induced nephropathy, CIN) is the serious complications after the application of contrast medium, and is the third cause of the hospital acquired renal disease. Since the discovery of the first CIN, which has a history of50years, but there still has no unified definition and method of treatment, is still unclear in pathogenesis. This article aims to prevent the occurrence of CIN after angiography through the several markers discuss the effects of low-osmolar and nonionic contrast agent on renal functions.Methods:From November in2011to April in2012, we Collect315patients of cardiology of Provincial Hospital Affiliated to Shandong University.There are210men and105female, aged33-85years old, average (59.27±9.94years old). All patients underwent coronary angiography coronary lesions clearly and diagnosed as coronary heart disease, patients were immediately given saline500ml and other measures. On the preoperative and third day after postoperative5ml of fasting blood is extracted, Determination of Scr,(32-microglobulin, as well as the urine specific gravity of preoperative and third days after postoperative. According to CIN definitions and preoperative, postoperative results of Scr, divided into CIN group (n=19) and non CIN group (n=296); according to the preoperative patients with and without renal dysfunction, diabetes into kidney function not devoid of diabetic group, without renal dysfunction diabetic group, renal function no diabetes, renal dysfunction associated with diabetes group; according to the contrast agent dose divided into small dose group (40-100ml), middle dose group(100-200ml), high dose group (>200ml).The experimental results are in said to average±STDEV, and application of SPSS19.0statistical software packages for statistical analysis.Results:(1) In315patients,231men,84women,19cases CIN,the incidence of CIN is6.03%.In the renal insufficiency diabetes mellitus group, of CIN reach4/8, and renal function normal group, renal insufficiency group compared, the difference was statistically significant (P<0.05,P<0.01).(2) in16CIN patients, the third day after imaging, Scr, beta2-micro globulin, SG after angiography three days (P>0.05).(3)Average dose CIN group contrast to (318.4+/-153.8ml, the CIN group for (227.9+/-121.9) ml, two groups of comparisons difference was statistically significant (P<0.01).(4) Angiography after dose group of Scr, beta2-micro globulin, SG with small dose group of moderate doses, comparing statistical significance (P<0.05,P<0.05); Moderate dose group of Scr, beta2-micro globulin, SG group compared with small dose difference was statistically significant (P>0.05).Conclusion:Merger renal insufficiency, dose is the contrast CIN independent risk factors.