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[EuroPCR 2011]陈韵岱专访——造影剂肾病的研究
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 编辑:国际循环网 时间:2011/6/7 16:10:27    加入收藏
 关键字:陈韵岱 造影剂肾病 

  Could you tell us a bit about yourself, your activities as a cardiologist and your centre?
  I am a professor of Medicine and Cardiology and Director of the Cardiology Division of the Chinese PLA General Hospital. My major clinical and research interest includes diagnosis and therapy of coronary disease, especially in the intervention of coronary disease. As the overall Principal Investigator for multi-centre clinical trials, my clinical research includes prevention and therapy on coronary artery disease in the Beijing region and comparison of different therapies (PCI, CABG, pharmacological) on CAD. In my cathlab, about 2,000 patients receive PCI therapy each year.
  作为一个心脏病专家,您能介绍一下您自己、您的工作和您所工作的中心吗?
  我是中国人民解放军总医院临床医学和心脏病学教授及心脏科主任。我的临床和科研的主要兴趣包括冠心病的诊断和治疗,尤其是冠心病介入治疗。作为多中心临床试验的首席研究员,我的临床研究包括北京地区的冠状动脉粥样硬化的预防和治疗及CAD不同治疗方法(PCI、CABG和药理学)的比较。在我的导管实验室,每年大约2000患者接受PCI治疗。
  Could you tell us about the prevalence of renal insufficiency in Chinese patients, the subject of your first contribution at the EuroPCR conference?
  The degree of renal impairment is a key risk factor for the development of renal complications for patients undergoing coronary angiography and elective PCI. The prevalence of renal impairment in these patients in China is not well-established. Our study gives, for the first time, a comprehensive estimation of the prevalence of renal impairment of Chinese patients undergoing coronary angiography and elective PCI. The prevalence of mild, moderate and severe renal insufficiency was 40.95%, 7.45% and 0.93%, respectively.
  您能给我介绍一下中国肾功能不全患者的患病率和您在EuroPCR会议上初次报告的主题内容吗?
  肾功能损害程度是冠状动脉造影和选择PCI患者发生肾脏并发症的关键危险因素。然而,中国这类患者的肾功能损害的患病率尚不完善。我们的研究初次提出了中国接受冠状动脉造影和PCI患者肾功能损害的全面估计。轻度、中度和重度肾功能不全的患病率分别为40.95%、7.45%和0.93%。
  You have completed a large scale randomised study with results that can be applied in daily practice across the cardiology community. We have much to learn from you, could you tell us something about this study?
  This direct study is the largest prospective randomised, double-blind comparison of the nephrotoxicity between different contrast media in renal risk patients undergoing cardiac catheterisation. This study aimed to compare the nephrotoxicity of low-osmolar, low-viscous iopromide and iso-osmolar, high-viscous iodixanol in Chinese patients with moderate renal dysfunction, who were undergoing coronary angiography or PCI. The study showed that the incidence of CIN is very low in the study patients with stringent hydration. The nephrotoxicity of LOCM iopromide compared to IOCM iodixanol was found not to be statistically different.
  您已经完成了大规模随机试验并能将结果应用于心脏科领域中的日常实践,有许多值得我们学习的地方,能否介绍一下您的研究?
  该直接研究是最大的前瞻性随机双盲对照试验,在接受心脏导管的肾脏风险患者对比不同造影剂的肾毒性。这项研究目的:在中国接受冠状动脉造影或PCI的中度肾功能不全患者中对比低渗低粘性碘普罗胺,高渗高粘性碘克沙醇的肾毒性。该研究表明,CIN在接受严格水化患者中的发生率非常低。LOCM碘普罗胺和IOCM碘克沙醇在肾毒性差异无统计学意义。
  In your institution, where there is a large volume of interventions and angiographies, what is your prevention protocol for contrast-induced nephropathy in routine practice for patients with renal insufficiency?
  In our institution, hydration is the most important prophylactic treatment in order to prevent CIN. All patients with moderate renal impairment should receive the method of prophylactic hydration, administered with 500 ml of 0.9% saline for at least 6 hours before a cardiac catheterisation procedure, followed by 1000 ml of 0.9% saline intravenously from the start of the procedure at 1 –1.5 ml/kg per hour.The patients with severe renal impairment usually need to take dialysis. As for the patientswith mild renal impairment, we usually don’t give them special treatment compared with those with normal renal function.
  在您的机构中有大量的介入和造影治疗,在肾功能不全患者造影剂肾病的常规治疗中,您的预防方案是怎样的?
  在我们的机构中,水化是防止CIN的预防性治疗中最重要的措施。所有中度肾功能损害的患者都应该接受预防性水化,在心导管插入术前给予0.9%生理盐水500ml至少6小时,在手术开始后经静脉0.9%生理盐水1000ml, 操作开始后给予1~1.5ml/kg·h。对于严重肾功能损害的患者通常需要接受血液透析。而对于轻度肾功能损害的患者则与肾功能正常患者一样无需特殊治疗。


  选自《EuroPCR每日新闻》

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