贫血对冠心病患者 PCI 术后并发对比剂肾病的影响

Predictability of Anemia on Contrast Induced Nephropathy after Percutaneous Coronary Interven-tions

【目的】探讨分析贫血与冠心病患者行经皮冠状动脉介入术（PCI）后发生对比剂肾病（CIN）的相关性。【方法】择2010年1月至2014年12月在四川省巴中市中心医院心内科行 PCI 术的冠心病患者700例，根据相关血液实验室检查结果将其分为贫血组（n=132）和非贫血组（n=568）。抽取所有患者入院时、PCI 术后48 h空腹静脉血，检测其血红蛋白（Hb）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FPG）、肾功能及其他标志物并估算肾小球滤过率（eGFR）。所有患者在发病后3 d 内行超声心动图检查并计算左心室射血分数（LVEF）。采用多元 Logistic 回归分析 PCI 术后发生贫血的危险因素及 CIN 影响因素。【结果】多元 Logistic 回归分析显示，贫血是 PCI 术后患者发生 CIN 的危险因素，而高龄、肾功能不全及 LVEF ≤50%是冠心病患者发生贫血的危险因素。【结论】无论患者是否伴有肾功能不全，贫血均是冠心病患者 PCI 术后发生CIN 的危险因素。

[Objective]To investigate the correlation of anemia with contrast induced nephropathy （CIN）after percutaneous coronary intervention （PCI）.[Methods]700 patients with coronary heart disease （CHD）underwent PCI in Sichuan Bazhong Central Hospital were selected from January 2010 to December 2014,.All the patients were divided into the anemia group （n =132）and the non anemia group （n =568）according to the related blood laboratory results.Fasting venous blood of all the patients both on admission and 48 h after PCI operation were ex-tracted respectively to detect the hemoglobin （Hb）,total cholesterol （TC）,three acyl glycerin （TG）,high-densi-ty lipoprotein （HDL-C）,fasting plasma glucose （FPG）,renal function and other markers.The eGFR was also es-timated.All the patients were taken echocardiographic examinationand and left ventricular ejection fraction （LVEF）calculation in 3d after onset.Multiple Logistic regression analysis of risk factors for PCI post operation were used to evaluate anemia and CIN influencing factors.[Results]Multivariate Logistic regression analysis showed that anemia was a risk factor of CIN after PCI,and advanced age,renal dysfunction,LVEF≤50% were all risk factors of anemia in CHD patients.[Conclusion]Anemia is a risk factor of CIN in CHD patients after PCI regardless of renal dysfunction or not.