摘要
目的:分析不同剂量二甲双胍对急性心肌梗死(AMI)合并2型糖尿病患者经皮冠状动脉介入术(PCI)后造影剂肾病(CIN)发病率的影响。方法:收集2019年1月~2021年6月在某院行PCI术的150例AMI伴2型糖尿病患者作为研究对象,根据二甲双胍的使用剂量进行分组,分为对照组、低剂量组和高剂量组各50例,对照组不使用二甲双胍,低剂量组二甲双胍使用量≤1000mg/d,高剂量组二甲双胍>1000 mg/d,观察并比较3组患者CIN发生率,并分析CIN的危险因素。结果:PCI术后CIN发生率比较,对照组为18.00%,低剂量组为22.00%,高剂量组为26.00%,3组比较差异均无统计学意义(P>0.05)。以CIN为因变量,将年龄、性别、BMI、高血压、二甲双胍使用量、造影剂用量、HbAlc、eGFR等作为自变量实施Logistic回归分析,结果表明CIN的独立危险因素为年龄>75岁、造影剂用量≥150 mL、术前eGFR<60 mL/min。结论:二甲双胍的使用剂量并不会增加AMI合并2型糖尿病患者PCI术后CIN发病率,但年龄超过75岁、术中造影剂用量及eGFR可增加CIN发病率风险,应引起重视。
Objective:To analyze the effect of different doses of metformin on the incidence of contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)complicated with type 2 diabetes mellitus.Methods:150 AMI patients complicated with type 2 diabetes who underwent PCI in a hospital from January 2019 to June 2021 were recruited as study subjects.According to the use dose of metformin for grouping,all patients were divided into the control group(50 patients,without metformin),the low dose group(50 patients,with the metformin use≤1000 mg/D).and the high dose group(50 patients,with the metformin use>1000 mg/D).The incidence of CIN in the three groups was observed and compared,and the risk factors for CIN were analyzed.Results:The incidence of CIN after PCI was 18.00%in the control group,22.00%in the low-dose group,and 26.00%in the high-dose group,with no statistically significant difference among the three groups(P>0.05).Logistic regression analysis was implemented with CIN as dependent variable and age,gender,BMI,hypertension,metformin use,contrast medium use,HbAlc,and eGFR as independent variables,and the independent risk factors for the development of CIN were age>75 years,contrast medium use≥150 ml,and preoperative EGFR<60 ml/min.Conclusion:The dose of metformin does not increase the incidence of CIN after PCI in AMI patients with type 2 diabetes mellitus,but the age over 75 years,the amount of intraoperative contrast medium and eGFR can increase the risk of CIN incidence,therefore,it should be paid attention.
作者
盛青江
Sheng Qingjiang(Department of Cardiovascular Medicine,Jinshui District General Hospital,Zhengzhou 450000)
出处
《数理医药学杂志》
CAS
2022年第4期548-550,共3页
Journal of Mathematical Medicine
