摘要
目的:多中心调查住院冠脉造影(CAG)和经皮冠状动脉介入术(PCI)患者造影剂肾病(CIN)的危险因素。方法:前瞻性收集上海浦东地区六家医院接受冠状动脉介入术患者的资料,分析造影剂肾病发生情况及相关危险因素。结果:入选患者197例,CIN发病率8.63%(17/197)。老年人(年龄≥70岁)72例(36.5%),糖尿病71例(36.0%),高血压148例(75.1%),心功能Ⅱ级以上者22例(11.2%)、心梗患者23例(11.7%)。发生CIN患者与非CIN患者在性别、年龄、2型糖尿病、术前心功能、血红蛋白、红细胞压积、总胆固醇、术前及术后肌酐清除率(Ccr)、术后血肌酐(Scr)、术后肾小球滤过率(GFR)、多只冠脉病变等方面差异有统计学意义(P<0.05)。相关分析Logistic多元逐步回归显示高龄(年龄≥70岁,相对危险度RR=7.3,P<0.05)、女性(RR=3.6,P<0.05)、心肌梗死(RR=5.6,P<0.05)、造影剂剂量≥180ml(RR=4.0,P<0.05)是CIN的危险因素。结论:心内科住院行CAG和PCI的患者CIN发生率较高,糖尿病、高血压、心功能不全等CIN公认的高危因素普遍存在;年龄70岁以上、女性、心肌梗死、较高造影剂剂量可能是心内科住院行CAG和PCI者CIN发生的危险因素。
Objective:To investigate the incidence of contrast-induced nephropathy (CIN) in patients underwent coronary angiography (CAG) and percutaneous coronary intervention (PCI).Methods:From April 2009 to July 2009,197 patients admitted to sixes centers in Pudong of Shanghai and treated with PCI and CAG were prospectively collected.Risk factors of CIN were analyzed.Results:Of 197 patients,17 experienced CIN (the incidence was 8.63%).72(36.5%) were aged (age≥70),71(36.0%) had diabetes mellitus,148(75.1%) hypertension,22(11.2%) heart function NYHA class〉Ⅱ,and 23(11.7%) myocardial infarction.There were significant difference between CIN and non-CIN patients in age,gender,diabetes mellitus,heart function,hemoglobin,haematocrit,cholesterol,creatinine clearance rate (Ccr) before and after CAG,serum creatinine and glomerular filtration rate (GFR) after CAG (P〈0.05).In multivariate analysis,age≥70 [relative ratio (RR)=7.3,P0.05],female (RR=3.6,P〈0.05),myocardial infarction (RR=5.6,P〈0.05) and contrast volume≥180 ml(RR=4.0,P〈0.05) were risk factors of CIN.Conclusion:It is deserved to pay attention to the incidence of CIN in hospitalized patients undergoing PCI and CAG.The risk factors of CIN are very universal.Female,age≥70,myocardial infarction and contrast volume≥180 ml are the potential risk factors for CIN.
出处
《中国中西医结合肾病杂志》
2010年第3期214-218,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
上海市浦东新区科技发展基金项目(No.PKJ2009-Y12)
上海市黄浦区科委研究项目[No.(2009)HGG-14]
上海市浦东社会发展局科研基金资助项目(No.PW2007D-3)
上海市重大科研项目(No.08DZ1900500)
上海市教委基金资助项目(No.06B2028)
仁济-基础医学院合作项目(No.06BZ028)
关键词
冠状动脉造影
经皮冠状动脉介入术
造影剂肾病
危险因素
Coronary angiography Percutaneous coronary intervention Contrast-induced nephropathy Risk factor