The Study Of Hydration In Contrast-Induced Nephropathy After Percutaneous Coronary Intervention

[Background] With the mature and development of Cadiovascular diagnosis and treatment technology,Percutaneous coronary intervention play an important role in the diagnosis and treatment of cardiovascular.Intervention therapy of cardiovascular disease patients has increaced year by year. Contrast-induced nephropathy (CIN) is an acute decline in renal function after the administration of intravenous contrast in the absence of other causes, It is the third leading cause of an acute renal failure in hospitalized patients. Including drugs, hydration, contrast agent and other improvements, hydration is almost universally accepted as an appropriate and safe measure to prevent CIN. Hydration have positive prevention function to CIN After PCI.This paper respectively use two kind of methods to control(the intravenous infusion of physiological saline (standard hydration) and oral rehydration salt) to prevent CIN.To evaluate the incidence of CIN by serum creatinine and cystatin C (CystC). In order to guide the clinical diagnosis and prevention of CIN.[Subjects and Methods] From March2010to October2011,2461coronary heart disease patients from Affliated hospital of jining medical college were enrolled into the present study, and retain2461sera from these patients, Selecte360suitable serum(Preparation).Female136, male224.360patients were randomly divided into3groups, All patients in abnormal group were gaven normal saline by vein. All patients in vein group were gaven normal saline by vein,at12h before scheduled time for coronary angiogram, conculation formula:weight×1.5ml×12h). And oral rehydration salt group (All patients in oral rehydration salt group were gaven oral rehydration salt by oral at6h before scheduled time for coronary angiogram, conculation formula:weight×3.0ml×6h).Everyone drips normal saline1000ml after percutaneous coronary intervention (PCI), And collect the serum before therapy and after PCI. Test the Scr and Cyst C by affiliated hospital of jining medical college department of biochemistry. Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure occurring within48-72h of exposure to intravascular radiographic contrast medium that is not attributable to other causes. In international literature a25%increase in serum creatinine levels or an increase in absolute values of0.5mg/dL from baseline has been suggested to define CIN.Reseach has found that, Cysteine protease inhibitor C (Cyst C) is a kind of marker that more ideal than serum creatinine to reflact the eGFR, the present study use cystatin C as an indicator of renal function, the risk factors of CIN were analied by regression analysis. All datas are applied SPSS13.0software to statistical analysis.[Results] The incidence of serum creatinine-based CIN was7.8%(n=28)in all, and16.7%(n=20) in control group、3.33%(n=4) in Intravenous hydration group、3.33%(n=4) in oral hydration group, and cystatin C-based CIN wasl6.9%(n=61) In all, and37.5%(n=45) in control group、6.67%(n=8) in Intravenous hydration group、6.67%(n=8) in oral hydration group. Creatinine and cystatin C two variable are correlation. Creatinine and cystatin C as a diagnose standard of CIN have a significant difference (P<0.01). Risk factors Analysis:smoking variables of years, contrast agent dosage, genetic, hypertension, diabetes, intervention methods are statistically significant. But sex, lesion count, LDL, uric acid do not show statistically significant differences.[Conclusion] In this study,1.The two hydration methods compare with control group were significant differences, hydration paly an important role in prevention of CIN.2.oral rehydration salt is has the advantages of simple, easy, safe, the compliance of patients with advanced features In the prevention of the occurrence of CIN.3. Cystatin C in diagnosis of CIN is more sensitive than Scr. But it is only a reference index on the diagnosis of CIN.4.The occurrence of CIN is closely associated with risk factors.such as smoking, contrast agent dosage, genetic, hypertension, diabetes, intervention methods and CIN.