期刊文献+

造影剂肾病临床相关因素分析 被引量:17

Investigation of risk factors of contrast-induced nephropathy
下载PDF
导出
摘要 目的:探讨冠状动脉造影(CAG)和经皮冠状动脉介入术(PCI)患者造影剂肾病(CIN)的危险因素。方法:回顾性分析北京安贞医院2006年1月至2011年10月行CAG或介入治疗患者1 793例,分析CIN发生情况及相关危险因素。所有患者均应用低渗非离子造影剂。结果:CIN总发生率为7.81%(140/1 793),CIN发生率随危险因素的增加而增高。与非CIN患者比较,CIN患者中的老年患者(≥70岁)、女性患者、合并糖尿病、未水化治疗、多支血管病变及基础肾功能不全居多。多因素Logistic回归分析显示,年龄≥70岁、合并糖尿病、术前eGFR<60mL.min-1.1.73m-2、造影剂用量>150mL,是发生CIN的危险因素,水化是减少CIN发生的保护因素。结论:行CAG和PCI的患者CIN率为7.81%,CIN发生率随危险因素的增加而增高。其中年龄、合并糖尿病、术前肾功能不全及造影剂用量是CIN发生的危险因素,术前水化可减少CIN的发生。 Objective: To investigate the risk factors of contrast-induced nephropathy(CIN) in patients undergoing coronary angiography and/or percutaneous coronary intervention (PCI). Methods : 1 793 cases of coronary angiography and/or percutaneous coronary intervention (PCI) from January 2006 to October 2011 were enrolled in this study. The incidence of the risk factors of CIN were retrospectively analyze. All these patients used the low-osmolar, nonionic contrast medium. Results : Of the 1 793patients, 140 experienced CIN, and the overall incidence was 7.81%. The incidence of CIN was increased with the increasing of the number of risk factors. The age, sex, diabetic mellitus, basic renal dysfunction, hydration treatment, with multi-vessel disease and contrast medium dosage in CIN patients were significantly different from those in non-CIN patients. Multi- variate analysis demonstrated that the following variables remained to be significant factors correlating with CIN : age~〉70 years, diabetes mellitus, preoperative eGFR 〈 60 mL/( rain. 1.73m^2 ) and contrast volume 〉 150mL. Hydration is a protective factors, can reduce the incidence of CIN. Conclusion: The incidence of CIN was 7.81% among patients undergoing coronary angiography and/or percutaneous coronary intervention(PCI). The incidence of CIN was increased with the increasing of the number of risk factors. Age,accompanied with diabet- ic mellitus,renal dysfunction and contrast medium dosage are the risk factors. Hydration can reduce the inci- dence of CIN.
出处 《心肺血管病杂志》 CAS 2012年第5期560-564,共5页 Journal of Cardiovascular and Pulmonary Diseases
关键词 冠状动脉造影 经皮冠状动脉介入术 造影剂肾病 危险因素 Coronary angiography Percutaneous coronary intervention Contrast-induced nephropathy Risk factors
  • 相关文献

参考文献18

  • 1Solomon RJ,Mehran R, Natarajan MK, et al. Contrast induced nephropathy and long-term adverse events:Cause and effect. Clin J Am Soc Nephrol,2009, 4 : 1162-1169.
  • 2Liistro F, Falsini G, Bolognese L. The clinical burden of contrast media induced nephropathy. Ital Heart,2003,4:668-676.
  • 3Briguori C, Aimldi F, Morici N, et al. New Pharmacological proto- cols to prevent or reduce contrast-media nephropathy. Minerva C ardioa.ngiol, 2005,53 : 49 -58.
  • 4冠心病介入诊疗对比剂应用专家共识[J].中国心血管病研究,2010,8(12):881-889. 被引量:65
  • 5Bouzas-Mosquera A, Vaquez-Rodrfguez JM, Calvifio-Santos R, et al. Contrast-induced nephropathy and acute renal failure following emergent cardic catheterization : incidence, risk factors and prog- nosis. Rev Esp Cardiol,2007 ,60 :1026-1034.
  • 6Abe M, Kimura T, Mofimoto T, et al. Incidence of and risk fac- tors for contrast- induced nephropathy after cardiac catheter iza- tion in Japanese patients. Circ J,2009, 73:1518-1522.
  • 7McCullough PA, Adam A, Becker CR, et al. Epidemiology andprognostic implications of contrast-induced nephropathy. Am J Cardiol, 2006,98 : 5K-13K.
  • 8周力,陈晖,张侃,李虹伟.维生素C预防对比剂肾病的临床研究[J].心肺血管病杂志,2010,29(S1):88-88. 被引量:5
  • 9杨清,刘晓丽,王志坚,王建龙,聂斌,李艳芳,赵迎新,周玉杰.中性粒细胞明胶酶相关脂质运载蛋白对轻中度肾衰竭患者对比剂急性肾损伤的预测价值[J].心肺血管病杂志,2011,30(4):280-283. 被引量:13
  • 10Chong E, Poh KK, Liang S, et al. Risk factorsand clinical out- comes for contrast-induced nephropathy after percmaneous coro- nary intervention in patients with normal serum creatinine. Ann Acad Med Singapore, 2010,39:374-380.

二级参考文献63

  • 1李榕彬,梅荣,盖鲁粤.老年冠心病合并糖尿病患者造影剂肾脏损害预防性护理的研究[J].心肺血管病杂志,2010,29(S1):38-41. 被引量:3
  • 2周力,陈晖,张侃,李虹伟.维生素C预防对比剂肾病的临床研究[J].心肺血管病杂志,2010,29(S1):88-88. 被引量:5
  • 3Klein LW,Sheldon MW,Brinker J,et al.The use of radiographic contrast media during PCI:a focused review:a position statement of the Society of Cardiovascular Angiography and Interventions.Catheter Cardiovasc Interv,2009,74:728-746.
  • 4ESC Guidelines for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes.Chapter Contrast-Induced Nephropathy.Bassand et al.Eur Heart,2007,28:1598-1660.
  • 5中国医师协会心血管内科医师分会,中国医师协会循证医学专业委员会,中国老年学学会心脑血管病专业委员会.心血管疾病防治指南和共识2009.北京:人民卫生出版社,2009.
  • 6Singh J,Daftary A.Iodinated contrast media and their adverse reactions.J Nucl Med Technol,2008,36:69-74.
  • 7Nash K,Hafeez A,Hou S.Hospital-acquired renal insufficiency.Am J Kidney Dis,2002,39:930-936.
  • 8European Society of Urogential Radiology.Guidelines on Contrast Media.Version 6.0,2007.
  • 9McCullough PA,Wolyn R,Rocher LL,et al.Acute renal failure after coronary intervention:incidence,risk factors,and relationship to mortality.Am J Med,1997,103:368-375.
  • 10Mehta RL,Kellum JA,Shah SV,et al.Acute Kidney Injury Network:report of an initiative to improve outcomes in acute kidney injury.Crit Care,2007,11:R31.

共引文献79

同被引文献161

  • 1李文华,韩飞,李东野,徐通达,张延斌,朱红.前列地尔脂微球载体制剂对急性冠状动脉综合征患者介入治疗术后造影剂肾病的预防作用[J].中华临床医师杂志(电子版),2011,5(14):4228-4230. 被引量:12
  • 2周力,陈晖,张侃,李虹伟.维生素C预防对比剂肾病的临床研究[J].心肺血管病杂志,2010,29(S1):88-88. 被引量:5
  • 3骆金铠,于桂香.造影剂肾病的危险因素及护理预防[J].中华护理杂志,2007,42(6):546-548. 被引量:63
  • 4Riambau V,da Rocha M.Is femorofemoral crossover bypass anoption in claudication?Ann Vasc Surg,2010,24:828-832.
  • 5Kashyap VS,Pavkov ML,Bena JF,et al.The management of se-vere aortoiliac occlusive disease:endovascular therapy rivals openreconstruction.J Vasc Surg,2008,48:1451-1457.
  • 6McCullough PA. Contrast-induced acute kidney injury[J]. J Am Coil Cardiol, 2008,51 : 1419-1428.
  • 7Solomon R,Mehran R,Natarajan M,et al. Contrast-induced nephropathy and long-term adverse events: cause and effect[J]. Clin J Am Soc Nephrol, 2009,4(7) : 1162-1169.
  • 8Parfrey P. The clinical epidemiology of contrast-induced nephropathy[ J ]. Cardio Vasc Int Radiol, 2005,28 (2) : S3-S11.
  • 9person PB,Hansell P, Liss P. Pathophysiology of contrast medi- um-induced nephropathy[ J ]. Kidney Int, 2005,68 : 14-22.
  • 10McCullough PA, Adam A,Becker CR,et al. Epidemiology and prognostic implications of contrast-induced nephropathy[J]. Am J Cardiol, 2006,98 : 5K- 13K.

引证文献17

二级引证文献68

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部