中医证型分布与冠状动脉介入术后造影剂肾病的相关性研究

目的探讨冠心病患者择期冠状动脉介入术后造影剂肾病(CIN)与中医证型的分布规律及相关性。方法采用回顾性研究的调查方法,按纳入标准及排除标准收集中国中医科学院西苑医院临床病例共466例,依据术后是否发生CIN分为CIN组与非CIN组,记录患者基础资料、生化、手术、中医四诊、辨证分型等相关信息。观察分析CIN患者的中医证型分布特点,比较各中医证型患者经皮冠脉介入术(PCI)术后肾功能变化,分析CIN的危险因素。结果CIN患者的中医证型分布由多到少依次为阳气虚衰证、心肾阳虚证、寒凝血瘀证、气虚血瘀证、痰瘀互阻证、心肾阴虚证、气阴两虚证、心血瘀阻证、气滞血瘀证;不同证型CIN患者术后肾功能变化比较显示阳气虚衰证组与心肾阳虚证组血肌酐升高明显;通过Logistic回归分析提示阳气虚衰证、心肾阳虚证为CIN发生的独立危险因素。结论中医证型阳气虚衰证、心肾阳虚证与CIN的发生高度相关,可作为择期行PCI的冠心病患者发生CIN的预测因素。

Correlation between TCM Syndrome Type Distribution and Contrast-induced Nephropathy in Patients with Coronary Heart Disease Undergoing Percutaneous Coronary Intervention

Objective:To explore the correlation between TCM syndrome type distribution and contrast-induced nephropathy(CIN)in patients with coronary heart disease undergoing percutaneous coronary intervention(PCI).Methods:A retrospective study was conducted.According to the inclusion criteria and exclusion criteria,a total of 466 cases in Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine were collected.They were divided into the CIN group and non-CIN group based whether CIN was occurred postoperatively.The basic data,biochemical information,surgery,TCM syndrome type and other related information were recorded.The characteristics of TCM syndrome type distribution of CIN in patients with coronary heart disease undergoing PCI were observed and analyzed,the TCM syndrome type and renal function changes in CIN patients were compared,and the risk factors of CIN were analyzed.Results:The distribution of TCM syndromes in CIN patients with coronary heart disease undergoing PCI from more to less was Yang qi deficiency syndrome,Yang deficiency of heart and kidney syndrome,cold coagulation and blood stasis syndrome,Qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,Yin deficiency of heart and kidney syndrome,Qi yin deficiency syndrome,Heart blood stasis syndrome and Qi stagnation and blood stasis syndrome.The comparison of renal function changed in CIN patients with different TCM syndrome types showed that the Scr of Yang qi deficiency syndrome and Yang deficiency of heart and kidney syndrome were significantly different from those of other syndrome types.Logistic regression analysis indicated that Yang qi deficiency syndrome and Yang deficiency of heart and kidney syndrome were independent risk factors for CIN occurrence.Conclusion:The TCM syndrome type of Yang qi deficiency syndrome and Yang deficiency of heart and kidney syndrome are highly relevant to CIN,which can be used as the prediction factor for the occurrence of CIN in patients with coronary heart disease undergoing PCI.