摘要
目的探讨高血压患者中正常白蛋白尿组、微量白蛋白尿(MAU)组冠状动脉介入诊疗术后对比剂肾病(CIN)的发病率及它们之间的关系。方法选择自2009年4月至2011年4月在南京医科大学第一附属医院心内科接受冠状动脉介入诊疗术的高血压患者为研究对象,所有患者均使用低渗对比剂(碘海醇)。记录患者临床资料,测定患者造影前1、2、3d尿白蛋白/肌酐比值,造影前1周内(任意1d)及术后第2天(术后48h)的血肌酐值(SCr),通过MDRD公式计算肾小球滤过率(GFR)。所有患者根据尿微量白蛋白/肌酐比值分为2组:尿白蛋白/肌酐比值<30mg/g者为正常白蛋白尿组(A组),30~300mg/g者为MAU组(B组)。探讨2组患者术后CIN发病率与MAU的关系。结果 151例患者中有14例发生CIN,发病率为9·3%。A组CIN发病率为5·5%,B组为19·0%,2组间差异有统计学意义(P<0·05)。在术前GFR>75ml/min的患者中CIN发病率为4·4%,在GFR<75ml/min的患者中发病率50%,两者差异有统计学意义(P<0·05)。结论冠状动脉介入诊疗术后,MAU会增加CIN的发病风险,相比GFR,MAU能更好地预测CIN的发生。
Objective To evaluate the incidence of contrast-induced nephropathy (CIN) in hypertensive patients with normal albuminuria or microalbuminuria (MAU) undergoing coronary intervention and the relationship between MAU and the incidence of CIN. Methods 151 patients with hypertension undergoing coronary intervention from April 2009 to April 2011 were enrolled in this study. All patients used low-osmolality contrast media (iohexol). Clinical data were recorded. Urinary albumin/creatinine ratio was measured 1, 2, 3 d before angiography. The level of serum creatinine(SCr) was measured at any time a week before the angiography and at the time of 48 hours after operation. Glomerular filtration rate (GFR) was calculated by MDRD formula. All the patients were divided into two groups according to urinary albumin/creatinine ratio: normal albuminuria group (group A) with a urinary albumin/creatinine ratio of 〈30 mg/g, MAU group (group B) with a ra- tio of 30-300 mg/g. The relationship between MAU and the incidence of CIN in two groups was investigated. Results Among all the 151 patients, CIN occurred in 14 patients with an incidence of 9. 3%. The incidence rate of CIN in group A was 5.5% ,compared with 19.0% in group B(P 〈0.05). The incidence rate of CIN in the patients with GFR 〉75 ml/min was 4. 4%, compared with 50% in patients with GFR 〈 75 ml/min ( P 〈0. 05 ). Conclusions In hypertensive patients, MAU will increase the risk of CIN. Compared with GFR, MAU can better predict the occurrence of CIN.
出处
《实用老年医学》
CAS
2011年第4期292-294,共3页
Practical Geriatrics
关键词
微量白蛋白尿
冠状血管造影术
对比剂肾病
发病率
microalbuminuria
coronary angiography
contrast-induced nephropathy
incidence