经皮冠状动脉介入治疗术后对比剂肾病发病率及危险因素分析

The Incidence and Risk Factors for Contrast Induced Nephropathy after Percutaneous Coronary Intervention

目的:探讨经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)发病率及危险因素。方法:回顾性分析2008年1月—2010年12月行PCI术患者共1010例,根据CIN诊断标准将其分为CIN组171例(16.9%)和非CIN组839例,比较2组相关因素的差异,应用Logistic回归分析CIN危险因素。结果:2组年龄、血糖、血红蛋白、红细胞、红细胞比容、三酰甘油、胆固醇、高密度脂蛋白、低密度脂蛋白、收缩压、左室射血分数(LVEF)、白蛋白、肌酐清除率(Ccr)、榕血Ccr、对比剂用量差异有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,年龄≥70岁、心肌梗死、急诊PCI、糖尿病、低血压、贫血、Ccr≤60mL/min、对比剂用量>200mL、LVEF≤0.45是发生CIN的危险因素。结论:CIN是PCI术后常见并发症,对具备CIN危险因素的高危患者应引起临床上高度重视。

Objective： To investigate the incidence and risk factors for contrast induced nephropathy （CIN） after percuta neous coronary intervention （PCI）. Methods： A retrospective study was performed on 1 010 patients who had undergone PCI from January 2008 to December 2010. According to the diagnostic criteria for CIN, the patients were divided into CIN group and non-CIN group. The related factors were compared between the two groups. Logistic regression analysis was applied to determine the risk factors for CIN. Results： There were significant differences in the patient age and values of blood glucose hemoglobin, red blood cells, hematocrit, triacylglyeerol, cholesterol, high density lipoprotein, low density lipoprotein, systolic blood pressure, left ventricular ejection fraction （LVEF）, albumin, creatinine clearance （Ccr）, and contrast agent volume between two groups （P 〈 0.05 or P 〈 0.01）. Logistic regression analysis showed that age≥70 years, myocardial infarction, emergency PCI, diabetes mellitus, hypotension, anemia, Ccr≤60 mL/min, contrast agent volume〉200 mL and LVE≤0.45 were risk factors of CIN. Conclusion： CIN is a common complication after PCI. More attention should be paid to patients who have risk factors of CIN.