造影剂滥用导致造影剂肾病的相关因素分析  

Analysis of Related Factors of Contrast Induced Nephropathy Caused by Abuse of Contrast Medium

作　　者：张绪吉[1] 王辉霞[1] 刘翔宇[1] ZHANG Xuji;WANG Huixia;LIU Xiangyu(Department of intervention,People’s Hospital of Jiaozuo City,Jiaozuo,Henan Province,454002)

机构地区：[1]河南省焦作市人民医院介入科,河南焦作454002

出　　处：《中国药物滥用防治杂志》2021年第2期207-210,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨造影剂滥用所导致的造影剂肾病(contrast-induced nephropathy,CIN),并分析CIN的相关因素。方法:回顾性分析该院2017年1月—2020年3月收治的行造影剂相关影像学检查患者312例,依据患者发生CIN情况进行分组,将出现CIN患者纳入CIN组、其他患者纳入对照组,采集两组患者疾病及自身情况资料加以比较,经Logistics回归分析确定CIN的影响因素。结果:312例患者中存在CIN共72例,发生率占23.08%;CIN组与对照组间的并发症发生率、造影剂用量、甘油三酯、造影前肾毒性药物摄入、体质量、水化疗法应用率比较,差异有统计学意义(P<0.05);经Logistic回归分析可知,2型糖尿病、高血压、心肌梗死、造影剂用量、甘油三酯、肾毒性药物摄入是发生造影剂肾病的危险因素(OR>1,P<0.05),水化疗法属于CIN的保护性因素(OR<1,P<0.05)。结论:造影术前应充分了解患者的甘油三酯水平、合并糖尿病、高血压、心肌梗死患者避免碘造影剂高剂量应用,术前停用肾毒性药物,强化水化疗法干预,促进造影剂的合理化使用,以避免造影剂滥用风险。Objective:To investigate the contrast induced nephropathy(CIN)caused by contrast agent abuse and analyze the related factors of CIN.Methods:A retrospective analysis of 312 cases of patients with contrast agent related imaging examination in the hospital from January 2017 to March 2020 was conducted.According to the occurrence of CIN,the patients with CIN were divided into the CIN group and other patients were included in the control group.Collected the data of the two groups of patients’diseases and their own conditions to compare,and determine the influencing factors of CIN by Logistics regression analysis.Results:There were 72 cases of CIN in 312 patients,accounting for 23.08%;there were statistically significant differences in the incidence of complications,dosage of contrast agent,triglyceride,intake of nephrotoxic drugs before angiography,body weight and application rate of hydration therapy between CIN group and control group(P<0.05);Logistic regression analysis showed that type 2 diabetes mellitus,hypertension,myocardial infarction,dosage of contrast medium,triglyceride and nephrotoxic drug intake were risk factors for contrast induced nephropathy(OR>1,P<0.05).Hydration therapy was a protective factor for CIN(OR<1,P<0.05).Conclusion:Patients with triglyceride level,diabetes mellitus,hypertension and myocardial infarction should be fully understood before angiography.High dose of iodine contrast agent should be avoided.Nephrotoxic drugs should be stopped before angiography.Hydration therapy should be strengthened to promote the rational use of contrast agent,so as to avoid the risk of agent abuse.

关 键 词：造影剂 造影剂肾病 老年 糖尿病 高脂血症 

分 类 号：R969.3[医药卫生—药理学]