造影剂相关急性肾损伤患者短期不良预后的危险因素分析

目的分析造影剂相关急性肾损伤(CI-AKI)患者短期不良预后的危险因素。 方法选择64例经冠状动脉造影(CA)或经皮冠状动脉介入治疗(PCI)术后的AKI患者。短期不良预后包括住院死亡和持续性肾功能不全。采用单因素和多因素Logistic回归分析CI-AKI患者短期不良预后的危险因素。 结果CI-AKI患者住院病死率为7.8%,存活患者发生持续性肾功能不全率为59.3%。单因素Logistic回归分析结果显示,心脏骤停、心源性休克、收缩压、肌酸激酶同工酶和合并慢性阻塞性肺疾病可能是CI-AKI患者住院死亡的危险因素；估算肾小球滤过率(eGFR)、手术时间、造影剂剂量、造影剂种类、Mehran风险评分和合并糖尿病可能是CI-AKI患者出现持续性肾功能不全的危险因素。多因素Logistic回归分析结果显示,心源性休克是CI-AKI患者住院死亡的独立危险因素；eGFR、手术时间和造影剂种类是CI-AKI患者持续性肾功能不全的独立危险因素。 结论心源性休克、eGFR、手术时间及造影剂种类是CA/PCI术后CI-AKI患者短期不良预后的独立危险因素。

Risk factor analysis for short-term adverse prognosis in patients with contrast-induced acute kidney injury

AimTo analyze the risk factors for short-term adverse prognosis in patients with contrast-induced acute kidney injury (CI-AKI). Methods64 patients with AKI after coronary angiography (CA) or percutaneous coronary intervention (PCI) were enrolled. The short-term adverse prognosis included in-hospital death and persistent renal dysfunction. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of short-term adverse prognosis in patients with CI-AKI. ResultsThe in-hospital mortality of patients with CI-AKI was 7.8%; persistent renal dysfunction occurred in 59.3% of surviving patients. Univariate Logistic regression analysis showed that cardiac arrest, cardiogenic shock, systolic pressure, creatine kinase isoenzymes and chronic obstructive pulmonary disease may be the risk factors for in-hospital mortality in patients with CI-AKI; estimated glomerular filtration rate (eGFR), duration of procedure, contrast media dose, contrast media category, Mehran risk score and diabetes mellitus may be the risk factors of persistent renal dysfunction in patients with CI-AKI. Multivariate Logistic regression analysis showed that cardiogenic shock is an independent risk factor for in-hospital mortality; eGFR, duration of procedure and contrast media category were independent risk factors for persistent renal dysfunction in patients with CI-AKI. ConclusionCardiogenic shock, eGFR, duration of procedure and contrast media category were independent risk factors for short-term adverse prognosis in patients with CI-AKI after CA/PCI.