造影剂肾病对冠心病并发慢性心力衰竭患者预后的影响  

Influence of contrast-induced nephropathy on the prognosis of patients with coronary heart disease and chronic heart failure

作　　者：卢旭升[1] 许贤彬[1] 杨平珍[2] 林锐波[1] 吴平彬[1] 

机构地区：[1]潮州市中心医院心血管内科,广东潮州521000 [2]南方医科大学珠江医院心血管内科,广州510282

出　　处：《岭南心血管病杂志》2017年第1期62-66,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨造影剂肾病(contrast-induced nephropathy,CIN)对冠状动脉粥样硬化性心脏病(冠心病)并发慢性心力衰竭(心衰)患者临床预后的影响。方法自2010年1月至2013年12月,连续入选于潮州市中心医院心内科接受经皮冠状动脉内支架植入术的冠心病并发慢性心衰的患者455例,并进行1年随访。根据是否发生CIN分两组,比较其临床特点及1年随访病死率。结果 455例患者中,男316例,女139例,发生CIN32例(7.0%);CIN组中高龄患者(>75岁)10例(31.6%),吸烟患者17例(55.1%),糖尿病患者17例(55.4%),急性心肌梗死伴休克患者5例(17.4%);CIN患者与非CIN患者上述指标比较,差异有统计学意义(P<0.01)。CIN组与非CIN组SYNTAX积分[(34.6±11.6)分vs.(21.6±7.8)分,P<0.01]、左心室射血分数(37.5%±9.87%vs.43.76%±3.45%,P<0.01)比较,差异均有统计学意义。CIN组在随访期间病死率显著高于非CIN组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,CIN是冠心病并发心衰患者1年死亡时间的独立危险因素。结论 CIN的发生与冠心病并发慢性心衰1年死亡风险显著相关。Objectives To investigate the influences of contrast-induced nephropathy（CIN）on the clinical prognosisin patients with coronary heart disease and chronic heart failure.Methods We consecutively selected 455 patientswith coronary heart disease and chronic heart failure who visited Chaozhou Central Hospital from January 2010 toDecember 2013 for undergoing percutaneous coronary stent implantation,and were followed up for one year.Accordingto the occurrence of CIN,these patients were divided into two groups.Clinical characteristics and 1-year follow-upmortality of these two groups were compared.Results Of all the 455 patients（male 316 cases,female 139 cases）,the number of patents with CIN was 32（7.0%）,in which there were 10（31.6%）elderly patients（75 years）,17（55.1%）smokers,17（55.4%）patients with diabetes and 5（17.4%）patients with acute myocardial infarction andshock.When comparing CIN patients with non-CIN patients,the differences of the upper indexes were statisticallysignificant（P〈0.01）.Average SYNTAX score in CIN group was 34.6±11.6,in non-CIN group was 21.6±7.8;meanleft ventricular ejective fraction（LVEF）in CIN group was 37.5%± 9.87%,in non-CIN group was 43.76% ± 3.45%;the differences between the two groups were statistically significant（P〈0.01）.During 1-year follow-up,the mortalityof CIN group was significantly higher than than that of non-CIN group.（P〈0.05）.Multivariate Logistic regressionanalysis showed that CIN was an independent risk factor for the 1-year death time in the coronary heart disease pa-tients with heart failure.Conclusions The CIN is significantly correlated with the 1-year mortality risk in patientswith coronary heart disease and chronic heart failure.

关 键 词：冠状动脉疾病 造影剂肾病 心力衰竭 预后 

分 类 号：R541.4[医药卫生—心血管疾病]