冠状动脉粥样硬化性心脏病介入术后发生造影剂肾病的相关因素分析

Correlation factors of contrast-induced nephropathy after coronary artery intervention among patients with coronary atherosclerotic heart disease

目的分析冠状动脉粥样硬化性心脏病患者行冠状动脉介入操作后发生造影剂肾病(CIN)的危险因素及相关性。方法 650例冠状动脉粥样硬化性心脏病患者使用造影剂威视派克行介入操作,分析入选病例的基础资料、CIN的发病率,分组讨论CIN发生的相关危险因素。结果 650例冠状动脉粥样硬化性心脏病患者行冠脉介入后有56例发生CIN(发病率为8.6%),使用较高剂量造影剂(≥95 mL)、左心收缩功能不全、2型糖尿病、高龄、eGFR<60 mL/(min.1.73m2)、诊断为急性冠脉综合征、合并高血压、存在冠脉病变的患者CIN发病率较高(P<0.05)。Logistic回归分析显示eGFR<60 mL/(min.1.73m2)(RR=6.50,P=0.003)、诊断急性冠脉综合征(RR=2.67,P=0.049)、高血压(RR=5.11,P=0.036)是CIN发病的危险因素。结论造影剂剂量较大、左心收缩功能不全、2型糖尿病、高龄、eGFR<60 mL/(min.1.73m2)、诊断急性冠脉综合征、高血压、存在冠脉病变等高危因素的患者CIN发病率高,eGFR<60 mL/(min.1.73m2)、诊断急性冠脉综合征、高血压可能是CIN发生的危险因素。

Objective To analyze the correlation factors of contrast-induced nephropathy（CIN） in coronary atheroscle rotic heart disease patients underwent coronary artery intervention.Methods 650 patients were admitted the Department of Cardiology of the First Affiliated Hospital of Xinxiang Medical College and treated with coronary artery inter vention,basic data were collected respectively,and overall incidence of CIN and risk factors of CIN were analyzed.Results Of the 650 patients,56 cases suffered with CIN（the incidence was 8.6%）.The CIN incidences in patients of contrast media volume ≥95 mL,left ventricular systolic dysfunction,type 2 diabetes,aged patients,eGFR ＆lt;60 mL/（min.1.73m2）,diagnosis of acute coronary syndrome,and patients with hypertension,multiple vessel disease were higher（P ＆lt; 0.05）.Multivariate Logistic regression analysis indicated that eGFR＆lt;60 mL/（min.1.73m2）（RR = 6.50,P = 0.003）,diagnosis of Acute Coronary Syndrome（RR = 2.67,P = 0.049）,hypertension（RR = 5.11,P = 0.036） were the risk factors for CIN.Conclusion Larger dose of contrast agent,left ventricular systolic dysfunction,type 2 diabetes,advanced age,eGFR ＆lt;60 mL/（min.1.73m2）,diagnosis of acute coronary syndrome,hypertension,the presence of coronary lesions and other risk factors in patients have a high incidence of CIN.eGFR ＆lt;60 mL/（min.1.73m2）,diagnosis of acute coronary syndrome,hypertension may be risk factors for CIN occurred.