肾功能正常或轻度损害患者接受冠状动脉造影术后发生对比剂肾病的危险因素分析

Risk factors of contrast-induced nephropathy in the patients with normal and slightly impaired renal function after selective coronary angiography

目的研究eGFR≥60mL.min-1.1.73m-2的患者在冠状动脉造影术后的对比剂肾病(contrast-induced nephropathy,CIN)发病率,分析CIN发病的临床危险因素。方法收录2009年2月至12月在复旦大学附属华山医院择期行冠脉造影术、eGFR≥60mL.min-1.1.73m-2的患者中发生CIN的病例,并行性别、年龄配对分析。用病例报告表记录患者的基线资料,用Logistic回归分析CIN的临床危险因素,用SPSS软件进行统计分析。结果 543例接受血管造影术且eGFR≥60mL.min-1.1.73m-2的患者中共17例发生CIN,发病率3.13%。CIN发病的临床危险因素包括基线高敏C反应蛋白(high-sensieivity C-reactive protein,hs-CRP)水平升高及术前未连续口服阿司匹林(100mg/天)超过1月。结论在eGFR≥60mL.min-1.1.73m-2的患者中,CIN发病率<5%,发病危险因素可能为基线hs-CRP水平升高和术前未连续口服阿司匹林1月以上。

Objective To analyze the morbidity and the clinical risk factors of contrast-induced nephropathy（CIN） in patients with normal and slightly impaired renal function.Methods Patients who developed CIN with estimated glomerular filtration rate（eGFR） up to 60 mL·min-1·1.73 m-2 and underwent selective coronary angiography（CAG） were included into the cohort from Feb.to Dec.in 2009.The GFR was estimated by MDRD formula according to the blood serum creatinine level.The baseline data of patients and the blood serum creatinine before CAG and within 48 hours after CAG were recorded into the database.Then SPSS software was used to analyze the morbidity and clinical risk factors of CIN.Results CIN occurred in 17 cases of 543 patients who accepted CAG therapy.The morbidity of CIN was 3.13%.By using Logistic regression,we found clinical risk factors of CIN included increased high-sensieivity C-reactive protein（hs-CRP） level and no preoperative use of aspirin up to one month.Conclusions The morbidity of CIN is below 5% in patients with eGFR≥60 mL·min-1·1.73 m-2.CIN risk factors include increased hs-CRP level and no preoperative use of aspirin.