急性心肌梗死病人经皮冠状动脉介入术后对比剂肾病的危险因素分析

目的:探讨急性心肌梗死病人经皮冠状动脉介入术(PCI)后发生对比剂肾病(CIN)的危险因素.方法:选取110例行急诊PCI治疗的急性心肌梗死病人,根据是否CIN分为CIN组和非CIN组,比较2组病人的一般资料、基础疾病、术前用药情况、对比剂使用情况等,分析CIN的危险因素.结果:2组病人的性别、年龄、体质量指数、血糖水平和血脂异常、高血压、既往心肌梗死、既往脑梗死例数差异均无统计学意义(P>0.05),而2组的肾功能不全、糖尿病、贫血例数和血清肌酐(SCr)、超敏C反应蛋白(hs-CRP)、血红蛋白水平及肾小球滤过率(eGFR)、左心室射血分数(LVEF)、肌酸激酶(CK)峰值、对比剂用量(CMV)差异均有统计学意义(P<0.05~P<0.01).其中,肾功能不全、SCr、eGFR、CMV、CMV/eGFR和LVEF、hs-CRP、对糖尿病、贫血均为CIN的独立影响因素(P<0.05~P<0.01).结论:除一般认为的肾功能不全、大剂量对比剂等危险因素外,糖尿病、高水平hs-CRP和CMV/eGFR等CIN危险因素也需引起足够重视.

Risk factor analysis of contrast-induced nephropathy in acute myocardial infarction patients treated with percutaneous coronary intervention

Objective:To study the related risk factors of contrast-induced nephropathy(CIN) of acute myocardial infarction(AMI) patients treated with percutaneous coronary intervention ( PCI ) . Methods:One hundred and ten patients with AMI were treated with PCI,and divided into the CIN group and non-CIN group. The general information, underlying diseases, premedication and dosage of contrast agent between two groups were compared,and the risk factors of CIN were analyzed. Results:The differences of the gender, age,body mass index, blood sugar level, dyslipidemia, hypertension, myocardial infarction and cerebral infarction between two groups were not statistically significant(P>0. 05). The differences of the renal insufficiency,diabetes,anemia,SCr,hs-CRP,eGFR,LVEF,CK and CMV between two groups were statistically significant(P<0. 05 to P<0. 01). The renal insufficiency,SCr,eGFR,CMV,CMV/eGFR,hs-CRP,LVEF,diabetes and anemia were the independent influencing factors of CIN(P<0. 05 to P<0. 01). Conclusions:The renal insufficiency and large dose of contrast agent are the risk factors of CIN,and the diabetes,high hs-CRP and CMV/eGFR also need to cause enough attention among the risk factors of CIN.