低渗造影剂对急性冠脉综合征行冠脉介入治疗患者肾功能的影响及相关因素分析

Effect of the low-osmolality nonionic contrast media on renal function in acute coronary syndrome patients undergoing percutaneous coronary intervention

目的通过对急性冠脉综合征（ACS）行冠脉介入治疗（PCI）患者造影剂肾病（CIN）发病情况的分析,以期了解低渗非离子造影剂对肾功能的影响及相关的危险因素。方法ACS行PCI患者204例,所有患者均应用低渗非离子型造影剂。检测术后7 d血肌酐水平,计算肌酐清除率（Ccr）,确定CIN。分析低渗造影剂对ACS行PCI患者肾功能的影响,并经多因素分析系统分析其他可能影响CIN的危险因素。结果204例患者中发生CIN6例,发生率2.94%。6例患者中,5例Ccr〈60 mL/min,1例30-60 mL/min。造影剂剂量和患者术前原有肾功能不全是CIN发生的独立危险因素。结论低渗非离子型造影剂对ACS患者肾功能有一定影响,原有肾功能不全患者CIN发病率较高,造影剂剂量和术前原有肾功能水平是CIN发生的独立危险因素。

Objective To analyse the effect of the low - osmolality nonionic contrast media on renal function in ACS patients undergoing percutaneous coronary intervention（ PCI）. To study the incidence and risk factors of contrast - induced nephropathy （ CIN ）. Methods 204 ACS patients undergoing PCI from September 2004 to September 2007 were enrolled in this study. All the patients accepted low - osmolality nonionic contrast media. To calculate the Ccr by measuring Scr level on 7th day after operation and to analyse the incidence of CIN. To observe the effect of low - osmolality nonionic contrast media on renal function in ACS patients undergoing PCI. Multivariate predictors of CIN were determined by using Logistic. Result Among the 204 patients, 6 patients had CIN, Ccr 〈 60 mL/min for 5 patients, 30 〈 Ccr 〈 60 mL/min for 1 patient, and the incidence of CIN was 2.94%, the volume of contrast media and pre -existed renal dysfunction were independent risk factors of CIN. Conclusion Effect of the low - osmolality nonionic contrast media on renal function in ACS patients undergoing PCI, the incidence of CIN in patients who had renal dysfunction is higher than that in other patients. The volume of contrast media and pre - existed renal dysfunction are independent risk factors of CIN.