Mehran评分用于老年人群造影剂肾病风险评估效果分析  

Effect Analysis of Mehran Score on the Risk Assessment of Contrast-Induced Nephrology in the Elderly

作　　者：裘齐宁 陆浩[2] 殷嘉晟[2] 徐烨 叶岩荣 章雯珺 QIU Qining;LU Hao;YIN Jiacheng;XU Ye;YE Yanrong;ZHANG Wenjun(Zhongshan Hospital,Fudan University,Xiamen,Fujian,China 361015;Zhongshan Hospital,Fudan University,Shanghai,China 200032)

机构地区：[1]复旦大学附属中山医院厦门医院,福建厦门361015 [2]复旦大学附属中山医院,上海200032

出　　处：《中国药业》2024年第6期95-98,共4页China Pharmaceuticals

基　　金：上海市临床重点专科项目[shslczdzk06504]。

摘　　要：目的验证Mehran评分用于老年冠状动脉粥样硬化性心脏病(简称冠心病)人群造影剂肾病(CIN)风险评估的效果。方法收集上海某院心血管内科2015年1月至2017年12月行经皮冠状动脉介入(PCI)术老年(>65岁)患者的临床资料(包括基本信息、合并症、实验室指标及合并用药情况),采用单因素和二元Logistic回归分析评估发生CIN的危险因素及与Mehran评分的相关性。结果共纳入378例患者,其中45例(11.90%)围术期发生CIN,Mehran分级为低危(≤5分)、中危(6~10分)、高危(11~15分)、极高危(≥16分)的患者分别有182例、147例、41例、8例,且各组患者CIN发生率差异有统计学意义(P<0.05)。二元Logistic回归分析结果表明,术前预估肾小球滤过率(eGFR)[OR=0.939,95%CI(0.883,0.998),P=0.044]及Mehran危险分级为高危[OR=3.414,95%CI(1.116,10.441),P=0.031]和极高危[OR=9.604,95%CI(1.311,70.355),P=0.026],是预测老年冠心病患者PCI术后发生CIN的重要因素。结论术前eGFR及Mehran危险分级为高危、极高危,为预测老年冠心病患者PCI术后CIN发生风险的影响因素。Objective To verify the effect of Mehran score applied in the risk assessment of contrast-induced nephropathy(CIN)in elderly patients with coronary heart disease(CHD).Methods The clinical data(including basic information,complications,laboratory indicators,combined medication)of elderly patients(>65 years)underwent percutaneous coronary intervention(PCI)in the Department of Cardiovascular Medicine of a hospital in Shanghai from January 2015 to December 2017 were collected.The univariate analysis and binary Logistic regression analysis were used to evaluate the risk factors for CIN and its correlation with Mehran score.Results A total of 378 patients were included,of which 45(11.90%)had CIN during the perioperative period;182,147,41,eight patients had low risk(≤five points),medium risk(six to ten points),high risk(11 to 15 points),extremely high risk(≥16 points)respectively based on the Mehran grading,and the incidence of CIN in each group was significantly different(P<0.05).The binary Logistic regression analysis showed that the preoperative estimated glomerular filtration rate(eGFR)[OR=0.939,95%CI(0.883,0.998),P=0.044],high risk of Mehran grading[OR=3.414,95%CI(1.116,10.441),P=0.031]and extremely high risk of Mehran grading[OR=9.604,95%CI(1.311,70.355),P=0.026]were important factors in predicting the occurrence of CIN in elderly patients with CHD after PCI.Conclusion Preoperative eGFR,high risk,extremely high risk of Mehran grading are the influencing factors in predicting the occurrence of CIN in elderly patients with CHD after PCI.

关 键 词：老年 冠状动脉粥样硬化性心脏病 经皮冠状动脉介入术 造影剂肾病 Mehran评分 风险预测 

分 类 号：R969.3[医药卫生—药理学]