脑血管病患者全脑血管造影术后致造影剂肾病相关危险因素研究  

Risk factors related to contrast nephropathy after whole cerebral angiography in patients with cerebrovascular disease

作　　者：黄炜超[1] 李递通[1] 陈锦俭[1] 冯伟明[1] 邓鹏飞[1] Huang Weichao;Li Ditong;Chen Jinjian;Feng Weiming;Deng Pengfei(Department of Neurology,the Yulin Second People's Hospital,Guangxi 537000,China)

机构地区：[1]玉林市第二人民医院神经内科,广西537000

出　　处：《脑与神经疾病杂志》2023年第11期669-672,共4页Journal of Brain and Nervous Diseases

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20211519)。

摘　　要：目的探讨脑血管病患者行全脑血管造影术(DSA)后致造影剂肾病(CIN)的发病率及相关危险因素.方法选取2021年7月-2023年6月期间就诊玉林市第二人民医院神经内科住院治疗拟行DSA的脑血管疾病患者600例,根据DSA术后是否发生CIN将其分为CIN组(n=31)和非CIN组(n=569).比较两组年龄、性别、病史、吸烟、饮酒、药物、肾功能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600例患者中有31例患者发生CIN,发生率为5.2%.两组患者年龄、肾脏疾病病史、高血压糖尿病等慢性病史、吸烟、药物、术前血肌酐和术前肾小球滤过率(eGFR)、造影剂剂量比较(P<0.05).两组性别、饮酒、高脂血症病史、术前心功能比较(P>0.05).其中年龄≥75岁、慢性肾脏疾病史、高血压、糖尿病等病史、药物及造影剂剂量>100ml为DSA术后患者发生CIN的高危因素(P<0.05).结论DSA术后致CIN发病;年龄、慢性肾脏疾病史、高血压、糖尿病史、药物及造影剂剂量均为DSA术后患者发生CIN的独立危险因素.在进行DSA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 investigate the incidence of contrast nephropathy(CIN)and related risk factors after pancerebral angiography(DSA)in patients with cerebrovascular disease.Methods From July 2021 to June 2023,600 patients with cerebrovascular disease who were hospitalized in the Department of Neurology of Yulin Second People's Hospital for the treatment of DSA were selected,and they were divided into CIN group(n=31)and non-CIN group(n=569)according to whether CIN occurred afer DSA surgery.Comparingthe age,sex,medical history,smoking,alcohol consumption,drugs,renal function and contrast agent use of the two groups,Logistic regression analyzed the risk factors that may lead to CIN.Results CIN occurred in 31 of 600 patients,and CIN occurred in 5.2%.The two groups were compared in terms of age,history of renal disease,chronic history of hypertension and diabetes,smoking,drugs,preoperative serum creatinine and preoperative glomerular filtration rate(eGFR),and contrast agent dose(P<0.05).Gender,alcohol consumption,history of hyperlipidemia,and preoperative cardiac function between the two groups(P>0.05).Among them,age≥75 years old,history of chronic kidney disease,hypertension,diabetes and other medical history,drug and contrast agent dose>10Oml were the risk factors for CIN in patients after DSA surgery(P<0.05).Conclusions The incidence of CIN in patients after DSA surgery is low;age,history of chronic kidney disease,hypertension,diabetes mellitus,and drug and contrast dose were all independent risk factors for CIN in patients after DSA surgery.Before DSA treatment,the patient's physical condition should be comprehensively evaluated and effective measures should be taken to prevent the occurrence of CIN.

关 键 词：全脑血管造影 造影剂肾病 危险因素 慢性肾功能不全 

分 类 号：R743.32[医药卫生—神经病学与精神病学]