冠状动脉介入术患者对比剂肾病相关危险因素分析

肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (1): 24-28.

冠状动脉介入术患者对比剂肾病相关危险因素分析

南京大学医学院临床学院硕士研究生（许建国）；南京军区南京总医院心脏内科（南京，210002）

出版日期:2012-02-28 发布日期:2012-03-09

Related Factors of Contrast-Induced Nephropathy in Patients Undergoing Coronary Intervention

Department of Cardiology，Jinling Hospital, Nanjing University School of Medicine，Nanjing 21002,China

Online:2012-02-28 Published:2012-03-09

摘要/Abstract

摘要：

摘　要目的: 研究冠状动脉造影(CAG)和经皮冠状动脉介入治疗(PCI)患者对比剂肾病(CIN)的发病率及危险因素。方法:选择南京军区南京总医院2010年10月至2011年4月接受CAG和PCI的患者672例,以术后48h血清肌酐(SCr)较术前升高25%或升高44.2μmol/L(0.5mg/dl)作为CIN的诊断标准, 分析CIN的发病率及危险因素。结果: 672例患者中，年龄≥65岁者292例(43.5％)，冠心病588例(87.5％)，高血压461例(68.6％)，糖尿病144例(21.4％)，术前SCr≥110μmol/L者30例(4.5％)，贫血42例(6.3％)，服用血管紧张素转换酶抑制剂344例(51.2％)，利尿剂95例(14.1％)，二甲双胍39例(5.8％)，对比剂用量≥200ml者 237例(35.3％)。在672患者中55例(8.2％)发生CIN，发生CIN者与非CIN者在年龄≥65岁、冠心病、对比剂用量≥200ml、利尿剂等方面差异有统计学意义（P<0.05）。Logistic多因素回归分析显示, 年龄≥65岁、对比剂用量≥200 mL是CIN的独立危险因素。结论: 在CAG和PCI患者的CIN发病率较高，年龄≥65岁和对比剂用量≥200mL是其独立危险因素。

关键词: 冠状动脉介入术 , 对比剂肾病 , 危险因素

Abstract:

ABSTRACT Objective: To investigate the incidence and the rick factors of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). Methodology: From October 2010 to April 2011, a total of six hundred and seventy two cases undergoing CAG and PCI were recruited. CIN is identified if the serum creatinine is increased by 25% or 44.2μmol/L (0.5 mg/dl) of the baseline at 48 hours post procedure. The incidence and the rick factors of CIN were analyzed. Results: Of six hundred and seventy two patients, 292 cases (43.5%) were aged over ≥65, 588 (87.5%) had coronary heart disease, 461 (68.6%）had hypertension, 144 (21.4%) had diabetes mellitus, 30 (4.5%) had SCr more than 110μmol/L before procedure, 42 (6.3%) had anemia, 344 (51.2%) took ACEI, 95 (14.1%) took diuretics, 39 (5.8%) took metformins, and 237 cases (35.3%) had the volume of contrast media ≥200ml. Among the 672 patients, CIN occurred in 55 patients and the incidence of CIN was 8.2%.There were significant differences between CIN and non-CIN patients in terms of ages over 65, coronary heart disease, the volume of contrast meida ≥200ml. diuretics（P<0.05）. Logistic regression analysis showed that age ≥65, and the voluem of contrast media ≥200ml were independent risk factors of CIN. Conclusion: The incidence of CIN in patients undergoing CAG and PCI was higher. The age ≥65 and the volume of contrast meida ≥200ml were independent risk factors of CIN.

Key words: percutaneous coronary intervention , contrast-induced nephropathy , risk factor

许建国宫剑滨. 冠状动脉介入术患者对比剂肾病相关危险因素分析[J]. 肾脏病与透析肾移植杂志, 2012, 21(1): 24-28.

XU Jian-guo ,GONG Jian-bin. Related Factors of Contrast-Induced Nephropathy in Patients Undergoing Coronary Intervention[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2012, 21(1): 24-28.

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