脑血管造影介入术后对比剂致急性肾损伤的影响因素分析  

Analysis of related factors of acute renal injury caused by contrast medium after cerebral angiography

作　　者：刘梦雯 尹晓翔[1] LIU Mengwen;YIN Xiaoxiang(Image Center of the First Affiliated Hospital of Henan University, Kaifeng 475000, P.R.China)

机构地区：[1]河南大学第一附属医院影像中心,河南开封475000

出　　处：《医学影像学杂志》2020年第11期1998-2002,共5页Journal of Medical Imaging

基　　金：河南省医学科技攻关计划项目(编号:2018020313)。

摘　　要：目的探讨影响脑血管造影介入术后对比剂致急性肾损伤(CI-AKI)的影响因素。方法选取本院行脑血管造影介入术的136例患者临床资料。术后发生对比剂致急性肾损伤50例患者为A组,未出现急性肾损伤86例患者为B组。采用单因素分析和多因素Logistic回归分析影响术后发生对比剂致急性肾损伤的相关因素。结果经单因素分析发现,两组年龄、贫血、高尿酸血症、糖尿病、基础估算肾小球滤过率(eGFR)值及基础血肌酐值的比较,差异均有统计学意义(P<0.05);两组术前使用收缩血管药物、术前使用血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)、水化治疗、术中平均动脉压、术中对比剂用量及术后使用ACEI/ARB情况的比较,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析发现,年龄、贫血、糖尿病及基础eGFR值均是影响患者术后发生对比剂致急性肾损伤的相关因素(P<0.05)。结论老年(年龄≥60岁)、贫血、糖尿病、慢性肾脏病〔eGFR<60 ml/(min 1.73m2)〕是影响脑血管造影介入治疗术后患者发生对比剂致急性肾损伤的独立危险因素。Objective To analyze the related factors of contrast-induced acute kidney injury in patients after cerebral angiographic intervention.Methods A retrospective study was carried out to collect the clinical data of 136 patients who underwent cerebral angiographic intervention in our hospital.Among them,50 patients with contrast-induced acute kidney injury were in group A,and the remaining 86 patients without acute renal injury were in group B.Univariate analysis and multi factor Logistic regression analysis were used to analyze the related factors of acute renal injury caused by contrast medium.Results Univariate analysis showed that there were significant differences between the two groups in age,anemia,hyperuricemia,diabetes mellitus,basic estimated glomerular filtration rate(eGFR)and basic blood creatinine(P<0.05);the two groups used vasoconstrictor,angiotensin-converting enzyme inhibitors(ACEI)/angiotensin receptor blocker(ARB)and water before operation were statistically significant differences in chemotherapy,intraoperative mean arterial pressure,intraoperative contrast agent dosage and postoperative ACEI/ARB use(P<0.05).By multivariate logistic regression analysis,we found that age,anemia,diabetes mellitus and basic EGFR were all related factors(P<0.05).Conclusion The elderly(age≥60 years old),anemia,diabetes,chronic kidney disease eGFR<60 ml/(min1.73 m2)are independent risk factors for the occurrence of contrast-induced acute renal injury in patients after cerebral angiographic intervention.

关 键 词：脑血管造影介入术 急性肾损伤 对比剂 估算肾小球滤过率 危险因素 

分 类 号：R815[医药卫生—放射医学] R743[医药卫生—临床医学]