摘要
目的 探讨急性冠状动脉综合症(ACS)患者经皮冠状动脉介入治疗(PCI)术后发生对比剂肾病(CIN)的危险因素。方法 回顾性分析2016年8月至2018年5月接受PCI治疗ACS患者318例,根据患者CIN发生情况被分为非CIN组292例(91.8%)和CIN组26例(8.2%),对于患者临床基线资料和可能影响CIN发病的危险因素进行分析和筛选。结果 CIN组患者年龄[(59.5±13.1)岁比(53.6±12.9)岁,P=0.037]、贫血(15.4%比4.8,P=0.043)、糖尿病(30.8%比14.0%,P=0.039)、慢性肾病(19.2%比5.1%,P=0.018)、肌酐[(69.97±25.81)μmol/L比(61.91±24.53)μmol/L,P=0.041]和对比剂用量[(219±87)mL比(163±79)mL,P=0.012]均高于非CIN组,非CIN组患者左心室射血分数(LVEF)(57.9±6.7%比51.9±7.2%,P=0.043)高于CIN组。Logistic回归分析显示、贫血、糖尿病、慢性肾病、LVEF降低、肌酐升高和造影剂用量增加是CIN发生的主要危险因素。结论 高龄患者合并有贫血、糖尿病、慢性肾病或心功能不全,如在术中大量应用对比剂会增加CIN发病风险。
Objective To explore the risk factors of contrast-induced nephropathy(CIN)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI). Methods We retrospectively analyzed 318 cases of ACS receiving PCI treatment from August 2016 to May 2018.According to the occurrence of CIN,the patients were divided into non CIN group 292 cases(91.8%)and CIN group 26 cases(8.2%).We analyzed clinical baseline data and risk factors for CIN. Results Patients in the CIN group were older and with more comorbidities of anemia,diabetes and Chronic kidney disease(all P <0.05).The levels of creatinine and the volume of contrast medium in group CIN were higher than those in non CIN group(all P <0.05).Left ventricular ejection fraction(LVEF)in non CIN group was higher than that in CIN group( P <0.05).Logistic regression analysis showed that anemia,diabetes mellitus,chronic kidney disease,decreased LVEF,elevated creatinine and increased dosage of contrast media were the main risk factors for CIN. Conclusion Elderly patients with anemia,diabetes,chronic kidney disease or cardiac insufficiency,such as intraoperative use of contrast agents will increase the risk of CIN.
作者
艾民
颜昌福
张思艺
夏福纯
Ai Min;Yan Changfu;Zhang Siyi(Pangang General Hospital of Kunming University of Science and Technology,Sichuan,Panzhihua 617023;Red Fruit Center Hospital of Yanbian County,Panzhihua,Sichuan 617107,China)
出处
《四川医学》
CAS
2019年第5期441-444,共4页
Sichuan Medical Journal
基金
四川省卫生和计划生育委员会科研课题(编号:18PJ378)
关键词
急性冠脉综合症
经皮冠状动脉介入治疗
对比剂肾病
acute coronary syndrome
percutaneous coronary intervention
contrast induced nephropathy
