摘要
目的:研究肾功能正常或轻度损害[估算肾小球滤过率(eGFR)≥60 ml/(min·1.73 m^2)]的急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后对比剂肾病的发生率,分析对比剂肾病发病的危险因素及主要不良心血管事件。方法:回顾2013-06至2015-06在第二炮兵总医院心血管内科行PCI的eGFR≥60 ml/(min·1.73 m2)的ACS患者254例。依据对比剂肾病定义[血清肌酐水平升高0.5 mg/dl(44.2μmol/L)或比基础值升高25%]分为对比剂肾病组(n=23)和非对比剂肾病组(n=231),记录所有患者的基线资料、实验室指标和手术指标,计算eGFR值。结果:254例eGFR≥60 ml/(min·1.73 m2)的ACS患者PCI术后23例发生对比剂肾病,发生率为9%。多元Logistic回归分析显示:急诊PCI(OR=0.370,95%CI:0.060~2.297)、N末端B型利钠肽原(NT-proBNP)水平(OR=4.209,95%CI:1.202~14.742)和既往未规律服用阿司匹林(OR=7.950,95%CI:1.108~57.034)是对比剂肾病发生的危险因素。结论:肾功能正常或轻度损害的ACS患者PCI术后对比剂肾病发生的危险因素是急诊PCI、NT-proBNP升高和既往未规律服用阿司匹林。
Objective： To evaluate the risk factors for contrast-induced nephropathy （CIN） in patients of acute coronary syndrome （ACS） with normal or slightly impaired renal function after percutaneous coronary intervention （PCI）. Methods： A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF〉60 ml （minol.73 m^2） and they were divided into 2 groups： CIN group, the patients with serum creatinine increased by 0.5mg/dl （44.2 μmol/L） or elevated to 25% higher than the baseline, n=23; Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients. Results： There were 9% （23/254） patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI （OR=0.370, 95% CI 0.060-2.297）, increased plasma level of NT-proBNP （OR=4.209, 95% CI 1.202-14.742） and without pre-operative aspirin administration （OR=7.950, 95% CI 1.108-57.034） were the clinical risk factors for post-operative C1N occurrence. Conclusion： Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.
出处
《中国循环杂志》
CSCD
北大核心
2016年第1期31-35,共5页
Chinese Circulation Journal
