冠心病患者经皮冠状动脉介入术后对比剂相关肾损伤的影响  

Risk Factors for Contrast-Induced Nephropathy After Percutaneous Coronary Intervention in Patients with Coronary Heart Disease

作　　者：王璟琨 俞婷婷 刘垚林 齐志敏 邹杰 斯柔青 WANG Jing-kun;YU Ting-ting;LIU Yao-lin;QI Zhi-min;ZOU Jie;SI Rou-qing(The 903rd Hospital of Joint Logistic Support Force of PLA,Hangzhou 310013,China)

机构地区：[1]联勤保障部队第903医院,浙江杭州310013

出　　处：《解放军药学学报》2025年第1期57-61,共5页Pharmaceutical Journal of Chinese People's Liberation Army

摘　　要：目的通过评估经皮冠状动脉介入术(PCI)前后的相关临床指标,回顾性分析对比剂相关肾损伤(CIN)的危险因素,以探讨对比剂引起急性肾损伤的风险因素,从而降低PCI术后CIN的风险并改善患者预后。方法采用回顾性分析,随机选取2022年6月1日-2023年12月31日在某医院心血管内科接受PCI术的74例患者作为研究对象。收集患者的基本信息、药物使用情况、对比剂类型及剂量、肾功能指标等临床数据,根据CIN的诊断标准(术后48 h内血清肌酐较术前升高25%或升高44.2μmol·L^(-1)以上),将患者分为CIN组和非CIN组,分析CIN的发生率,并通过单因素和Logistic多因素回归分析来确定CIN的风险因素。结果共纳入74例PCI患者,其中19例(25.6%)发生了CIN。CIN组与非CIN组在年龄、高血压病、糖尿病和高脂血症等指标上无统计学意义(P>0.05),但在性别、慢性肾功能不全病史、急性心肌梗死等方面有统计学意义(P<0.05)。两组对比剂碘普罗胺注射液用量比较,CIN组为(187.43±56.84)ml,非CIN组为(192.26±62.65)ml,差异无统计学意义(P>0.05)。Logistic多因素回归分析表明,男性、慢性肾功能不全病史和术前血清肌酐是CIN的独立危险因素,相对危险性依次为:男性、慢性肾功能不全病史、术前血清肌酐。结论慢性肾功能不全病史、男性和血清肌酐水平可能是CIN的独立危险因素。这些发现有助于在PCI术前评估患者CIN的风险,从而采取相应的预防措施。Objective To retrospectively analyze the risk factors for contrast-induced nephropathy(CIN)by evaluating clinical indicators before and after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods The clinical data of 74 patients who had undergone PCI in the Department of Cardiology between 2022 and 2023 was analyzed retrospectively.The clinical data included patients′basic information,medications,types and doses of contrast agents,and renal function indicators.Some patients were excluded from this study.Based on the diagnostic criteria for CIN(a 25%increase in serum creatinine(Scr)or more than 44.2μmol·L^(-1) within 48 hours post-operation),patients were divided into CIN and non-CIN groups.The incidence of CIN was analyzed,and risk factors were identified through univariate analysis and logistic multivariate regression analysis.Results Out of the 74 patients included in the study,19(25.6%)developed CIN.There was no statistically significant difference between the CIN and non-CIN groups in terms of age or incidences of hypertension,diabetes,and hyperlipidemia(P>0.05).However,there were significant differences in gender,history of chronic renal failure(CRF),and acute myocardial infarction(P<0.05).The comparison of contrast agent dosage between the two groups showed no significant difference(187.43±56.84)ml in the CIN group compared with(192.26±62.65)ml in the non-CIN group,P>0.05.Logistic multivariate regression analysis indicated that being male,having a history of chronic renal failure,and preoperative Scr were independent risk factors for CIN.Conclusion A history of chronic renal failure,being male,and serum creatinine levels may be independent risk factors for CIN.These findings can help assess the risk of CIN before PCI so as to take precautions.

关 键 词：对比剂相关肾损伤 冠心病 经皮冠状动脉介入术 

分 类 号：R965[医药卫生—药理学]