816例冠状动脉介入诊疗术患者造影剂肾病危险因素调查

Investigation of Risk Factors of Contrast-induced Nephropathy in 816 Patients Undergoing Coronary Artery Intervention

目的：了解经皮冠状动脉介入术(PCI)和冠状动脉造影术患者造影剂肾病危险因素的发生情况。方法：收集我院2004年7月 ～2005年3月期间住院的816例接受 PCI 和冠状动脉造影患者的资料，回顾分析造影剂肾病各危险因素的发生情况。所有患者均应 用低渗非离子造影剂。结果：816例患者中，男性572例，女性244例；平均年龄63． 5±11． 6岁；肾功能不全61例(7． 5％)，糖尿病90 例(11． 0%)，既有糖尿病又有肾功能不全11例(1． 34%)，充血性心衰55例(6． 7%)，用大剂量造影剂208例(25． 5%)，老年人397例 (48． 7%)，蛋白尿(＞2g/d)11例(1． 3%)，高血压407例(49． 9%)，高脂血症154例(18． 9%)，高尿酸血症69例(8． 5%)。816例患者中 无上述危险因素者共147例(18． 0%)，存在1项危险因素者296例(36． 4%)，存在2项危险因素者232例(28． 4%)，存在3项危险因素 者104例(12． 7%)，存在4项及以上危险因素者37例(4． 5%)，老年病人。肾功能不全和高血压发病率明显高于非老年人(P＜0． 05) ，肾 功能不全组高血压发生率明显高于肾功能正常组(P＜0． 05) 。结论：行冠脉造影和 PCI 术的患者，存在造影剂肾病的危险因素十分普 遍，早期给予积极而有效的预防措施十分必要。

Objective：To investigate the risk factors of contrast-induced nephropathy （CIN） in patients Underwent coronary artery angiography and/or percutaneous coronary fartery intervention （PCI）. Methods： From July 2004 to March 2005, eight hundred and sixteen patients admitted to our hospital were treated with PCI or coronary artery angiography. The incidence of the risk factors of CIN, Were retrospectively analyzed. All these patients used the low-osmolar, nonionic contrast medium. Results： Of 816 patients, 572 were male and 244 were female. The average age was 63. 5 ± 11.6 years. Sixty one patients （7. 5% ） had renal dysfunction, 90（11.0% ） diabetic mellitus, 11 （1.34%） had both renal dysfunction and diabetic mellitus, 55 （6. 7%） suffered congestive heart failure, 208（25. 5% ）accepted large dose contrast dye, 397（48.7% ） were elder people, 11 （ 1.3% ） had proteinuria（〉2g/d）, 407 （49. 9% ） hypertension, 154（ 18.9% ） hyperlipi- demia, 69（8. 5% ） hyperuricemia. There were 147 patients （18.0%） who had no such risk factors, 296（36. 4% ） had only one risk factor, 232（28. 4% ） had two , 104（12.7% ） had three, 37 （4. 5%） had four or above four risk factors. The morbidity of renal dysfunction and hypertension in old patients was higher than that in non-old patients （P〈0. 05）. The incidence of hypertension in patients with renal dysfunction was obviously higher than that with normal renal function （P〈0. 05）. Conclusion： In patients undergoing PCI and/or coronary artery angiography, the risk factors of CIN were very universal. It is necessary to take active and effective preventive measures in early stage.