天津医药

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经皮冠状动脉介入治疗术后对比剂肾病发病率及危险因素分析

杨世诚   

  1. 天津医科大学研究生院
  • 收稿日期:2011-04-21 修回日期:2011-06-01 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 杨世诚

The incidence of and risk factors for contrast induced nephropathy after percutaneous coronary intervention

  • Received:2011-04-21 Revised:2011-06-01 Published:2011-10-15 Online:2011-10-15

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摘要： 摘要 目的：探讨经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）术后对比剂肾病（contrast induced nephropathy, CIN）发病率及危险因素。方法：回顾性调查天津市胸科医院心内科2008年1月至2010年12月行PCI术共1010例患者，根据CIN诊断标准将其分为CIN组和非CIN组，比较两组之间相关因素的差异，应用Logistic回归分析确定CIN危险因素。结果： 1010例患者中有171例发生CIN，发病率为16.9%。CIN组与非CIN组间在年龄、血糖、血压、血脂、红细胞、血红蛋白、血细胞压积、血管病变数目、肌酐清除率（Ccr）、左室射血分数（LVEF）、对比剂剂量方面差异有统计学意义（P<0.05）；Logistic 回归分析发现: 年龄≥70岁、心肌梗死、急诊PCI、糖尿病、低血压、贫血、Ccr≤60ml/min、对比剂剂量>200ml、LVEF≤45%与CIN强相关。结论：CIN是PCI术后常见的并发症，应引起临床上高度重视。年龄≥70岁、心肌梗死、急诊PCI、糖尿病、低血压、贫血、Ccr≤60ml/min、对比剂剂量>200ml、LVEF≤45%是CIN的危险因素。

关键词: 对比剂肾病, 经皮冠状动脉介入治疗, 危险因素, 发病率

Abstract: Abstract Objective: To investigate the incidence of and risk factors for contrast induced nephropathy(CIN) after percutaneous coronary intervention(PCI). Methods:A retrospective study was performed on 1010 patients who had underwent PCI in cardiology department of Tianjin chest hospital from January 2008 to December 2010. According to the diagnostic criteria for CIN，the patients were divided into CIN group and non-CIN group, related factors were compared between the two groups. Logistic regression analysis was applied to determine the risk factors for CIN. Results: Among the 1010 patients, CIN occurred in 171 patients and the incidence of CIN was 16.9%. There were significant differences in age, blood pressure, blood glucose, lipid, hemoglobin, red blood cells, hematocrit, creatinine clearance(Ccr), left heart ejection fraction(LVEF), contrast media volume between the two groups. Logistic regression analysis showed that aged≥70 years, myocardial infarction, emergency PCI, diabetes mellitus , hypotention, anemia, Ccr≤60ml/min, contrast media volume>200ml, LVEF≤45% was strongly associated with CIN. Conclusion: Contrast induced nephropathy is a common complication after PCI, more attention should be paid in this complication in clinical. Aged≥70 years, myocardial infarction, emergency PCI, diabetes mellitus , hypotention, anemia, Ccr≤60ml/min, contrast media volume>200ml, LVEF≤45% were risk factors for CIN.

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