造影剂肾病发生的临床相关因素分析

A report about the cusing factors in contrast nephropathy

目的探讨冠状动脉造影后发生造影剂肾病(RCIN)的临床相关因素及术前水化的作用。方法回顾性分析2006年8月至2008年8月解放军总医院住院行冠状动脉造影患者279例,其中肾功能不全者给予水化,比较临床特点、造影当日静脉液体入量和造影前后血清肌酐的变化。结果RCIN总发生率6.81%(19/279),高血压患者中RCIN发生率为8.65%(16/185),糖尿病患者中RCIN发生率为12.1%(12/99),肾功能不全患者中RCIN发病率为0。多因素Logistic回归分析显示,与发生RCIN相关的因素分别是年龄、糖尿病、造影当日静脉补液量,与性别、吸烟、高血压、冠心病、肾功能不全无关。结论60岁以上人群RCIN的发生率较高,可能与肾脏储备能力降低有关;术前充分水化是减少RCIN发生的有效办法。

Objective To explore the causing factors of radiocontrast-induced nephropathy （RCIN） after coronary angiography and the rule of hydratation. Methods 279 cases of coronary angiography were retrospectively analyzed, and the chnical features, basic renal function and volume of intra-venous fluid received on operation day between the patients with and without RCIN were compared. Results The total mortality rates of radiocontrast-induced nephropathy were 6. 81% （19/279） ;in patients with hypertension, the RCIN rates were 8. 65 %. （16/185） ;in patients with diabetic, the RCIN rates were 12. 1% （12/99） ; in patients with preexisting renal dysfunction, the RCIN rate was 0% （0/16） ; the muhifactor Logistic analysis showed that the factors causing RCIN were age, diabetic, the volume of intra-venous fluid, however, the factors such as gender, smoking, hypertension, coronary heart disease, chronic renal failure were irrelative with RCIN. Conclusion ： The incidence of RCIN in people over 60 years old is much higher. Such condition may be partly cansed by the decreasing renal reserve capacity. Sufficient hydration is an effective way to decrease RCIN.