冠状动脉粥样硬化性心脏病介入操作后造影剂肾病发病的相关因素分析  

Correlation Factors of Contrast-induced Nephropathy after Coronary Artery Intervention among Patients with Coronary Atherosclerotic Heart Disease

作　　者：肖丹[1] 郭荣[1] 陈清勇[1] 于佳雪[1] 徐亚伟[1] 

机构地区：[1]同济大学附属第十人民医院心内科,上海200072

出　　处：《现代生物医学进展》2013年第9期1675-1681,共7页Progress in Modern Biomedicine

基　　金：国家自然科学基金(面上项目)(81070107)

摘　　要：目的:分析行冠状动脉介入操作后的冠状动脉粥样硬化性心脏病患者发生造影剂肾病的相关性及危险因素。方法:收集我院心内科2011年9月至2012年3月共计325例使用造影剂威视派克对行介入操作的冠状动脉粥样硬化性心脏病患者的临床资料,分析入选病例的基线资料和造影剂肾病(contrast-induced nephropathy,CIN)的发病率,分组讨论CIN发生的相关危险因素。结果:325例行冠脉介入的冠状动脉粥样硬化性心脏病患者中有28例发生CIN(发病率为8,6%),高龄、合并高血压、2型糖尿病、左心收缩功能不全、eGFR<60mL/min/1.73m2、使用较高剂量造影剂(≥95mL)、诊断为急性冠脉综合征、存在冠脉病变的患者CIN发病率较高(P<0.05)。logistic回归分析显示高血压(RR=5.11,P=0.036),诊断急性冠脉综合征(RR=2.67,P=0.049),eGFR<60mL/min/1.73m(2RR=6.50,P=0.003)是CIN发病的危险因素。结论:高龄,高血压,2型糖尿病,左心收缩功能不全,eGFR<60mL/min/1.73m2及造影剂剂量较大,诊断急性冠脉综合征,存在冠脉病变等高危因素的患者CIN发病率高。高血压,诊断急性冠脉综合征,eGFR<60mL/min/1.73m2可能是CIN发生的危险因素。Objective： To analyze the correlation factors of contrast-induced nephropathy （CIN） in coronary atheroselerotie heart disease patients underwent coronary artery intervention. Methods： From September 2011 to March 2012, 325 patients were admitted to the Department of Cardiology of the 10th People＇s Hospital and treated with coronary artery intervention, the baseline data was collected respectively, and overall incidence of CIN and risk factors of CIN were analyzed. Results： In the 325 patients, 28 eases developed CIN （the incidence was 8.6 %）. The CIN incidences of aged, hypertension, type 2 diabetes, left ventrieular systolic dysfunction, eGFR〈60 mL/ min/1.73 m^2, eontrast media volume t〉 95 mL, diagnosis of Acute Coronary Syndrome, multiple vessel disease （P〈0.05） is higher. Multiv- ariate logistic regression analysis indicated that hypertension （RR=5.11, P=0.036）, diagnosis of Acute Coronary Syndrome （RR=2.67, P--~.049）, eGFR〈60 mL/min/1.73 m^2 （RR=6.50, P=0.003） were the risk factors for CIN. Conclusion： The incidence of CIN was higher in aged patients, and patients with hypertension, type 2 diabetes, eGFR〈60 mL/min/1.73 m^2, left ventrieular systolic dysfunction, contrast media volume I〉 95 mL, diagnosis of Acute Coronary Syndrome, and multiple vessel disease. The risk factors of CIN may involve hypert- ension, diagnosis of Acute Coronary Syndrome, eGFR〈60 mL/min/1.73 m^2.

关 键 词：冠状动脉造影 经皮冠状动脉介入 造影剂肾病 发病率 

分 类 号：R541.4[医药卫生—心血管疾病]