行冠状动脉介入治疗的急性冠脉综合征患者发生对比剂肾病的危险因素分析

Risk factors for contrast-induced nephropathy in patients with acute coronary syndrome undergoing coronary interventional therapy

目的研究行冠状动脉介入治疗的急性冠脉综合征患者术后发生对比剂肾病的危险因素。方法2017年3月至2019年12月于我院行冠状动脉介入治疗的急性冠脉综合征患者,分为术后发生对比剂肾病的65例和未发生对比剂肾病的417例并进行评测。结果行冠状动脉介入治疗的急性冠脉综合征患者对比剂肾病发生率为13.49%,应用多因素logistic回归分析提示,肾功能不全(OR=32.850,95%CI为2.730-395.229)、心功能不全(OR=7.102,95%CI为3.060-16.482)是行冠状动脉介入治疗的急性冠脉综合征患者术后对比剂肾病发病的危险因素(P<0.05);年龄≤75岁(OR=0.209,95%CI为0.061-0.709)、水化(OR=0.085,95%CI为0.033-0.218)、血肌酐<0.5 mg/d L(OR=0.025,95%CI为0.003-0.252)是急性冠脉综合征患者冠状动脉介入治疗术后对比剂肾病发病的保护因素。结论急性冠脉综合征患者行冠状动脉介入治疗术后对比剂肾病发生率较高,心功能不全、肾功能不全、高龄、血肌酐≥0.5 mg/d L、未水化是急性冠脉综合征患者行冠状动脉介入治疗术后发生对比剂肾病的危险因素。

Objective To investigate the risk factors for contrast-induced nephropathy in patients with acute coronary syndrome undergoing coronary interventional therapy.Methods A retrospective analysis was performed for the patients with acute coronary syndrome who underwent coronary interventional therapy in Xingtai People’s Hospital from March 2017 to December 2019,among whom there were 65 patients with contrast-induced nephropathy and 417 patients without contrast-induced nephropathy.Results The incidence rate of contrast-induced nephropathy was 13.49%among the patients with acute coronary syndrome undergoing coronary interventional therapy.The multivariate logistic regression analysis showed that renal insufficiency(odds ratio[OR]=32.850,95%confidence interval[CI]:2.730-395.229,P<0.05)and cardiac insufficiency(OR=7.102,95%CI:3.060-16.482,P<0.05)were risk factors for contrastinduced nephropathy in patients with acute coronary syndrome undergoing coronary interventional therapy,while age≤75 years(OR=0.209,95%CI:0.061-0.709,P<0.05),hydration(OR=0.085,95%CI:0.033-0.218,P<0.05),and serum creatinine<0.5 mg/dL(OR=0.025,95%CI:0.003-0.252,P<0.05)were protective factors against contrast-induced nephropathy.Conclusion There is a high incidence rate of contrast-induced nephropathy in patients with acute coronary syndrome undergoing coronary interventional therapy,and cardiac insufficiency,renal insufficiency,old age,serum creatinine≥0.5 mg/dL,and absence of hydration are risk factors for contrast-induced nephropathy in such patients.