造影剂肾病发生的危险因素分析

Analysis of risk factor for contrast-induced nephropathy

目的通过对行冠状动脉介入治疗患者造影剂肾病(CIN)发病情况的分析,探讨低渗非离子型造影剂对肾功能的影响及相关危险因素。方法 150例冠状动脉介入治疗患者,所有患者均应用低渗非离子型造影剂。术后2 d检测血肌酐水平,观察CIN的发生情况,比较CIN患者和非CIN患者年龄、造影剂量、造影前血肌酐以及肾功能不全、高血压、高血脂、高尿酸血症、糖尿病发生情况。结果 150例患者中发生CIN14例,发生率为9.33%。CIN组患者年龄、造影剂量及造影前血肌酐值均显著高于非CIN组患者,差异有统计学意义(P<0.01)。CIN组患者肾功能不全、高血压、高血脂、糖尿病发生率均高于非CIN组,差异具有统计学意义(P<0.05)。结论存在高龄、造影剂量大、造影前血肌酐水平较高等高危因素的患者CIN发病率高。原有肾功能不全、高血压、高血脂、糖尿病可能是CIN发生的危险因素。

Objective To investigate influence by low osmolar nonionic contrast medium on renal function and its related risk factor by analyzing contrast-induced nephropathy（CIN） patients receiving coronary intervention for treatment. Methods A total of 150 patients in coronary intervention treatment all received low osmolar nonionic contrast medium. Their serum creatinine levels were detected in 2 d after operation, Observation was made on occurred CIN. Comparison was made on age, contrast dose, serum creatinine before radiography, renal insufficiency, hypertension, hyperlipidemia, hyperuricemia and diabetes mellitus between patients with and without CIN. Results Among the 150 patients, there were 14 case with CIN, with incidence as 9.33%. CIN group had obviously higher age, contrast dose and serum creatinine before radiography than nonCIN group, and their difference had statistical significance（P〈0.01）. CIN group had higher incidences of renal insufficiency, hypertension, hyperlipidemia and diabetes mellitus than non-CIN group, and the difference had statistical significance（P〈0.05）. Conclusion High morbidity rate of CIN occurs in patients with advanced age, large contrast dose and high serum creatinine before radiography as high risk factors. Risk factors of CIN include primary renal insufficiency, hypertension, hyperlipidemia and diabetes mellitus.