冠状动脉造影及介入治疗后造影剂肾病危险因素的Meta分析

Meta-analysis of the risk factors of contrast-induced nephropathy for patients after coronary angiography and interventional therapy

目的系统评价冠状动脉造影及介入治疗后患者发生造影剂肾病的危险因素。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国生物医学文献数据库、中国知网、维普数据库及万方数据库,收集关于冠脉造影及介入治疗后患者并发造影剂肾病危险因素的研究,检索时限为从建库-2020年1月。采用RevMan 5.3软件进行Meta分析。结果共纳入了18篇文献,包括15771例研究对象,发现年龄≥60岁(OR=2.59)、糖尿病(OR=2.51)、左室射血分数<50%(OR=2.82)、肾功能不全(OR=3.86)、尿酸(OR=1.54)、低血压(收缩压≤100 mmHg)(OR=4.17)、贫血(OR=1.81)、造影剂用量>200 mL(OR=3.28)、心肌梗死(OR=2.48)、慢性肾病(OR=4.91)、急诊经皮冠状动脉介入治疗(OR=2.61)、女性(OR=1.74)患者造影剂肾病危险性更高。结论造影剂肾病与上述12项危险因素有关,护士应加强对此类高危患者的正确识别,及时采取措施,预防造影剂肾病的发生。

Objective To determine the risk factors of contrast-induced nephropathy(CIN)for patients after coronary angiography and interventional therapy through meta-analysis.Methods Research on the risk factors of patients suffering from CIN after the coronary angiography and interventional treatment was searched in PubMed,Web of Science,Cochrane Library,Embase,China Biomedical Literature Database,China Knowledge Network,Weipu Database,and Wanfang Database with the search period from the construction of the database to January 2020.The RevMan 5.3 software was used to Meta-analysis.Results A total of 18 literatures were found,including 15771 study subjects.Patients with the age≥60 years(OR=2.59),diabetes(OR=2.51),and LVEF<50%(OR=2.82),renal insufficiency(OR=3.86),uric acid(OR=1.54),hypotension(systolic blood pressure≤100 mmHg)(OR=4.17),anemia(OR=1.81),dosage of contrast agent>200 mL(OR=3.28),myocardial infarction(OR=2.48),chronic kidney disease(OR=4.91),emergency PCI(OR=2.61)and sex of female(OR=1.74)had a significantly higher risk.Conclusion CIN is related to the above 12 risk factors.Nurses should correctly recognize such patients to take timely measures to prevent the occurrence of CIN.