经皮冠状动脉介入术后患者造影剂肾病危险因素分析.docVIP

精品论文 参考文献 经皮冠状动脉介入术后患者造影剂肾病危险因素分析 张萍1李亚男2张虹1 　　（1天津南开医院高级病房主治医师300000;2天津中医药大学天津300100） 　　作者简介：张萍（1979-），女，汉，天津市，本科，硕士，主治医师，从事心血管临床工作。【摘要】目的：研究冠心病患者经皮冠状动脉介入术(PCI)后造影剂肾病(CIN)的发生率及危险因素。方法：选择2011年6月～2012年12月接受PCI的600例患者,比较CIN组48例（8%）和非CIN组552例的资料，分析CIN的危险因素。结果：600例患者中,有48例(8%)发生CIN。Logistic多因素回归分析显示,与发生CIN相关的危险因素是年龄、糖尿病、肾功能不全、LVEFlt;40%、3支以上冠状动脉病变、对比剂剂量、服用二甲双胍(Plt;005)。肾功能不全和糖尿病是CIN的独立危险因素。结论：PCI术后发生CIN的发生率比较高，对具备CIN危险因素的高危患者应在术前积极做好评估和预防工作。 　　【关键词】造影剂肾病；经皮冠状动脉介入术；危险因素Analysis of percutaneous coronary intervention in patients with risk factors of contrast-induced nephropathy 　　Zhang PingLi YananZhang Hong(Tianjin Nankai Hospital Senior ward physician, Tianjing, 300000;Tianjin University of Traditional Chinese Medicine, Tianjing, 300100) 　　【Abstract】Objective: To study the incidence and the risk factors of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods: 600 patients undergoing PCI from June 2011 to December 2012 were enrolled in this study. The patients were divided into CIN group and non-CIN group,and the two groups were compared. Risk factors for CIN were analyzed.Results: In the 600 patients, 48 cases(8%) developed CIN. Identified by regression, the following variables may be the risk factors correlating with CIN: age, diabetes, renal insufficiency,LVEF lt;40%, three teams of coronary lesions, contrast agents dose and using metformin(P lt;005). Renal insufficiency and diabetes are independent risk factors of CIN.Conclusion: The incidence of CIN in patients undergoing PCI is relatively high. Measures should be performed before PCI to prevent CIN,especially in the hige-risk patients. 　　【Keywords】Contrast-induced nephropathy；Percutaneous coronary intervention；Risk factor 　　【中图分类号】R61【文献标识码】B【文章编号】1003-5028(2013)05-0272-02 　　经皮冠状动脉介入治疗（PCI）已成为治疗冠状动脉病变非常重要的手段，但其引发的造影剂肾病（CIN）增加了患者远期死亡率、中风和心脏病发作的风险［1］。本文通过回顾性分析我院心内科行PCI的患者资料，确立了CIN的两个独立危险因素,为确定CIN的高危人群并进行早期预防提供了参考。 　　1资料与方法 　　11临床资料:选择2