冠状动脉介入治疗术后对比剂肾损伤相关危险因素分析

目的:探讨冠状动脉介入治疗(PCI)术后对比剂肾损伤(CIN)发病情况及危险因素。方法:回顾性调查天津市胸科医院心内科2009-01-2010-12行PCI术的1 435例患者,根据是否发生CIN将其分为CIN组和非CIN组,比较2组之间相关因素的差异,应用Logistic回归分析确定CIN的危险因素。结果:1 435例患者中有211例发生CIN,发病率为14.7%;CIN组和非CIN组间年龄、红细胞计数、血红蛋白含量、贫血、血压、左室射血分数(LVEF)、肾小球滤过率(GFR)、对比剂用量等均差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示,年龄>70岁、糖尿病、低血压、贫血、LVEF≤45%、GFR≤60ml/(min.1.73m2)、对比剂用量>200ml、心肌梗死、急诊PCI是CIN的危险因素。结论:CIN是PCI术后较常见的并发症,对具备CIN高危因素的患者,临床医生应高度重视。

Study of risk factors for contrast induced nephropathy after percutaneous coronary intervention

Objective:To invetigate the incidence of contrast induced nephropathy(CIN) and identify the risk factors for CIN after percutaneous coronary intervention(PCI).Method:A retrospective study was conducted on 1 435 coronary heart disease patients who had underwent PCI from January 2009 to December 2010 in Tianjin Chest Hospital.According to the CIN critiria,the patients were divided into CIN group and non-CIN group.Logistic regression analysis was applied to determin the risk factors for CIN.Result:Among the 1 435 patients,CIN occurred in 211 patients and the incidence of CIN was 14.7%.There were significant differences in age,red blood cells,hemoglobin,anemia,systolic blood pressure,left ventricular ejection fraction(LVEF),glomerular filtration rate(GFR) and contrast agent volume between the two groups(P<0.05).Logistic regression analysis showed that age >70 years,diabetes mellitus,hypotension,anemia,LVEF≤45%,GFR≤60 ml/(min·1.73 m2),contrast agent volume >200 ml,myocardial infarction,urgent PCI were risk factors for CIN.Conclusion:CIN is a common complication after PCI,more attention should be paid to patients who have risk factors of CIN.