经皮冠状动脉介入治疗术后造影剂肾病发病的影响因素分析  

Influencing Factors of Contrast Induced Nephropathy after Percutaneous Coronary Intervention

作　　者：罗剑静 许碧夏[1] 曾映云 伍文锋 梁国泉 邓舒妮[1] LUO Jianjing;XU Bixia;ZENG Yingyun;WU Wenfeng;LIANG Guoquan;DENG Shuni(Zhaoqing Medical College,Zhaoqing 526020,China)

机构地区：[1]肇庆医学高等专科学校,广东肇庆526020 [2]广东省肇庆市第二人民医院

出　　处：《中国医学创新》2022年第32期100-104,共5页Medical Innovation of China

基　　金：2020年肇庆市科技创新指导类项目(202004030717)。

摘　　要：目的:了解经皮冠状动脉介入治疗(PCI)术后造影剂肾病(CIN)的具体发病情况,分析评价CIN患者发病的相关危险因素。方法:选取2020年6月-2022年2月肇庆市第二人民医院收治的200例冠心病。根据PCI术后是否发生造影剂肾病将其分为CIN组(n=21)和非CIN组(n=179)。比较两组年龄、性别、合并症、术前各项实验室指标、手术情况、病变情况及造影剂使用情况等资料,logistic回归分析可能导致CIN发生的危险因素。结果:200例患者中有21例患者发生CIN,CIN发生率为10.5%。两组年龄、吸烟、高血压、术前收缩压、术前肌酐和术前肾小球滤过率(eGFR)比较,差异均有统计学意义(P<0.05)。两组性别、高血脂、糖尿病、术前左室射血分数(LVEF)、总胆固醇、术前尿酸、低密度脂蛋白和高密度脂蛋白比较,差异均无统计学意义(P>0.05)。CIN组患者置入支架数少于非CIN组,支架总长度短于非CIN组,造影剂剂量高于非CIN组(P<0.05)。两组他汀类药物使用、靶血管血运重建、主动脉内球囊反搏、冠状动脉病变支数及造影剂接触时间比较,差异均无统计学意义(P>0.05)。年龄≥65岁、有高血压病史、术前eGFR<90 mL/(min·1.73 m^(2))及造影剂剂量>200 mL为PCI术后患者发生CIN的高危因素(P<0.05)。结论:年龄、高血压病史、术前eGFR及造影剂剂量均为PCI术后患者发生CIN的独立危险因素。在进行PCI治疗前,应综合评估患者机体状况,采取有效措施预防CIN的发生。Objective:To understand the specific incidence of contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI),and to analyze and evaluate the related risk factors of CIN.Method:A total of 200 patients with coronary heart disease admitted to Zhaoqing Second People’s Hospital from June 2020 to February 2022 were selected,the patients were divided into CIN group(n=21)and non-CIN group(n=179)according to the occurrence of contrast medium nephropathy after PCI.The age,gender,comorbidities,preoperative laboratory indicators,surgical conditions,lesions,and contrast media use were compared between the two groups.logistic regression analysis was performed to analyze the risk factors that may lead to CIN.Result:CIN occurred in 21 of 200 patients,and the incidence of CIN was 10.5%.There were significant differences in age,smoking,hypertension,preoperative systolic blood pressure,preoperative creatinine and preoperative glomerular filtration rate(eGFR)between the two groups(P<0.05).There were no significant differences in gender,hyperlipidemia,diabetes mellitus,preoperative left ventricular ejection fraction(LVEF),total cholesterol,preoperative uric acid,low density lipoprotein and high density lipoprotein between the two groups(P>0.05).The number of stents implanted in CIN group was less than that in non-CIN group,the total length of stents in CIN group was shorter than that in non-CIN group,and the contrast medium dose in CIN group was higher than that in non-CIN group(P<0.05).There were no significant differences in statin use,target vessel revascularization,intra-aortic balloon pump,number of coronary artery lesions,and contrast medium exposure time between the two groups(P>0.05).Age≥65 years,history of hypertension,preoperative eGFR<90 mL/(min·1.73 m^(2))and the dose of contrast media>200 mL were high risk factors for CIN after PCI(P<0.05).Conclusion:Age,history of hypertension,preoperative eGFR and dose of contrast agent are all independent risk factors for the occurrence of CIN in patients afte

关 键 词：经皮冠状动脉介入治疗 造影剂肾病 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R691[医药卫生—内科学]