目的 探讨冠状动脉CT血管造影(CT angiography,CTA)检查后1周内再次应用造影剂行冠状动脉介入诊疗对患者肾功能的影响.方法 将行冠状动脉介入诊疗患者384例分为试验组(1周内已行冠状动脉CTA检查,再次行冠状动脉造影者)135例和对照组(只行1次冠状动脉造影者)249例,监测2组术前和术后1d、2d、3d血肌酐、胱抑素C水平和造影剂肾病(contrast induced nephropathy,CIN)发生率.结果 2组血肌酐、估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)、胱抑素C水平组间差异均无统计学意义(P＞0.05),但时点间差异均有统计学意义(P＜0.01).共发生CIN 16例,试验组6例(4.44％),对照组10例(4.02％),2组CIN发生率差异无统计学意义(P＞0.05).试验组介入治疗率明显高于对照组(54.07％ vs 33.33％),其差异有统计学意义(P＜0.01).结论 eGFR≥60 mL·min-1·1.73 (m2)-1的患者行冠状动脉增强CTA后1周内进一步行冠状动脉介入诊疗对肾功能的影响较小,在临床中是安全可行的.%Objective The goal of this study was to investigate the effect on renal function in patients with coronary angiography or percutaneous coronary intervention(PCI) after coronary CT angiography(CTA) within 1 week.Methods A total of 384 patients underwent coronary angiography or angioplasty were enrolled into two groups:the test group 135 who were undergoing coronary angiography or angioplasty after coronary CTA within 1 week,and control group 249 who were undergoing coronary angiography only.Serum creatinine,cystatin C and the incidence of contrast induced nephropathy(CIN) were detected before procedure,after procedure 1 d,2 d,3 d.Results There was no significant difference in serum creatinine,estimated glomerular filtration rate (eGFR),and cystatin C between groups before and after contrast exposure(P ＞0.05).But there was significatnt difference between different point(P ＜0.01).The study resulted in 16 cases of CIN,and there was no significant difference in the incidence of CIN between two groups(4.44％ vs 4.02％,P＞0.05).The difference of PCI between the two groups was statistically significant(P＜0.01),and the PCI procedure in test group was significantly higher than that in control group(54.07％ vs 33.33％).Conclusion It is safe and feasible for patients with an eGFR≥60 mL · min-1 · 1.73 (m2)-1 to received coronary angiography or PCI after CTA within 1 week,and it has little impact on the renal function.
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