碘海醇所致造影剂肾病的危险因素分析

Risk factors of nephropathy induced by contrast agent iohexol

目的分析碘海醇所致造影剂肾病(CIN)的危险因素。方法收集在河北医科大学第一医院心内科行经皮冠状动脉造影的646例患者临床资料,根据造影剂肾病的诊断标准分为CIN组(n=116)和非CIN组(n=530),比较两组患者基础疾病、自身情况的差异,采用Logistic回归分析危险因素。结果 CIN组患者和非CIN组患者的2型糖尿病、慢性肾脏病、心力衰竭、低血压、心肌梗死、急诊PCI例数以及年龄、造影剂用量差异有统计学意义(P<0.05)。Logistic回归分析显示:2型糖尿病、慢性肾脏病、心力衰竭、低血压、心肌梗死、年龄≥70岁、造影剂用量≥200 ml、急诊PCI是发生造影剂肾病的危险因素。结论碘海醇所致造影剂肾病的发生受到基础疾病、自身情况、造影剂用量等因素的影响,对于存在CIN高危因素的患者应引起临床上的高度重视。

【Objective】To analyze the risk factors of nephropathy induced by contrast agent iohexol.【Methods】Totally 646 patients who received percutaneous coronary angiography in the Department of Cardiology in our hospital were enrolled and divided into contrast induced nephropathy（CIN） group（n = 116） and non CIN group（n = 530） according to diagnostic criteria of contrast induced nephropathy. Differences in underlying diseases and patient’s own situation were compared between the two groups, and the risk factors were analyzed by Logistic regression analysis.【Results】There were differences in the incidences of type 2 diabetes, chronic kidney diseases, heart failure, hypotension, myocardial infarction, emergency PCI cases and age, contrast agent volume between both groups（P 〈0.05）. Logistic regression analysis showed that type 2 diabetes, chronic kidney diseases, heart failure, hypotension,myocardial infarction, age older than 70 years, contrast agent volume ≥ 200 ml and emergency PCI were the risk factors of contrast induced nephropathy.【Conclusions】The occurrence of nephropathy induced by contrast agent iohexol is affected by underlying diseases, patient’s own situation and contrast agent volume. High attention should be paid to patients with high rick factors of contrast induced nephropathy.