冠状动脉介入术导致对比剂肾病危险因素分析  

The Risk Factors of Contrast-Induced Nephropathy in Percutaneous Coronary Intervention

作　　者：李华珍[1] 王红[1] 梁文武[1] 

机构地区：[1]广西医科大学第四附属医院心内科,广西省柳州市545005

出　　处：《中国动脉硬化杂志》2011年第6期529-532,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨冠状动脉介入术患者对比剂肾病的危险因素。方法收集我院2008年1月-2009年12月期间住院的172例接受冠状动脉介入术患者的临床资料,比较对比剂使用剂量,测定介入治疗前后血清肌酐,分析发生对比剂肾病危险因素。结果 172例患者发生对比剂肾病32例,发生率18.61%（32/172）,肾小球滤过率〉60 mL/min患者发生对比剂肾病21例（13%）,肾小球滤过率〈60 mL/min患者发生对比剂肾病19例（40%）（P〈0.001）,年龄≥75岁、3支病变、左心室射血分数〈40%、血清肌酐〉133μmol/L及对比剂剂量〉300 mL与对比剂肾病相关（P〈0.001）。糖尿病或高血压合并肾功能不全对比剂肾病发病率高于单纯糖尿病或高血压患者（P〈0.01）。结论介入治疗术前肾功能受损及其损害程度是术后出现对比剂肾病的最主要危险因素,肾功能不全、年龄≥75岁、多支冠状动脉病变、左心室射血分数〈40%、对比剂剂量〉300 mL均为对比剂肾病的独立危险因素。糖尿病或高血压病合并肾功能不全可以增加对比剂肾病的临床风险。Aim To investigate the risk factors of contrast-induced Nephropathy（CIN） in the percutaneous coronary intervention（PCI）. Methods To collect the clinical data of 172 patients who underwent the PCI from January,2008 to December,2009,compare contrast agents dose,recorded the creatinine（Cre） before and after treatment,and analyse the risk factors for occurrence of CIN. Results There were 32 cases occurred CIN,including 21 cases（13%） with GFR 60 mL/min,and 19 cases（40%） with GFR60 mL/min（P0.001）.The incidence rate was 18.61 %（32/172）.The following variables may be the significant factors correlating with CIN： aged≥75 years,three teams of coronary lesions,LVEF40%,Cre133 μmol/L and contrast agents dose300 mL（P0.001）.The incidence of CIN in those patients who had renal dysfunction combining with diabetes mellitus or hypertension was higher than those without renal dysfunction（P0.01）. Conclusion renal damage and the degree of it are the most significant risk factors of CIN development after PCI.Renal insufficiency,aged≥75 years,multivessel coronary artery disease,LVEF40%,and contrast agents dose300 mL,are all independent risk factors of CIN.Patients with diabetes or hypertension and pre-existing renal insufficiency have a greater risk of CIN.

关 键 词：对比剂肾病 危险因素 冠状动脉介入术 

分 类 号：R5[医药卫生—内科学]