冠状动脉介入诊疗术患者造影剂肾病的危险因素研究

山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (10): 98-101.

冠状动脉介入诊疗术患者造影剂肾病的危险因素研究

李海德，李贵双，张文泉，张玉红

教育部和卫生部心血管重构和功能研究重点实验室山东大学齐鲁医院心内科，济南 250012

收稿日期:2009-04-28 出版日期:2009-10-16 发布日期:2009-10-16
通讯作者: 李贵双(1963- )，男，博士，副教授，硕士生导师，研究方向为超声心动图及冠心病、先心病的介入治疗。E mail:lgs630322@yahoo.com.cn
作者简介:李海德(1978- )，男，硕士研究生，研究方向为超声心动图及冠心病、先心病的介入治疗。

isk factors of contrastinduced nephropathy in patients 
undergoing coronary artery intervention

LI Haide, LI Guishuang, ZHANG Wenquan, ZHANG Yuhong 

Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health;
Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, China

Received:2009-04-28 Online:2009-10-16 Published:2009-10-16

摘要/Abstract

摘要：

目的研究经皮冠状动脉介入术(PCI)和冠状动脉造影术患者造影剂肾病(CIN)的危险因素。方法选择2008年10月～2009年3月在齐鲁医院接受冠状动脉造影术和/或PCI的200例患者，分别监测造影前3?d内(任意1?d)和造影后第3、7天的血清肌酐(Scr)、尿素氮(BUN)和尿β2微球蛋白(β2MG)，分析冠状动脉诊疗术患者CIN的危险因素。结果200例患者中，有14例(7%)发生CIN。在CIN组和非CIN组，原有肾功能不全、糖尿病、高血压患者的比例，两组间比较，差异有统计学意义(P＜0.05)。年龄、身体质量指数(BMI)、血管紧张素转换酶抑制药(ACEIs)、冠状动脉粥样硬化、造影剂剂量和高脂血症, 两组间差异无统计学意义(P＞0.05)。logistic多因素逐步回归分析显示原有肾功能不全和糖尿病是CIN的独立危险因素。结论高血压是CIN的一个相关危险因素；年龄、BMI、ACEIs、冠状动脉粥样硬化、造影剂剂量和高脂血症等不是CIN的相关危险因素；原有肾功能不全和糖尿病是CIN的独立危险因素。

关键词: 冠状动脉造影术, 经皮冠状动脉介入术, 造影剂肾病, 危险因素

Abstract:

To study the risk factors of contrastinduced nephropathy(CIN)in patients undergoing coronary artery angiography and/or percutaneous coronary intervention(PCI). Methods200 patients undergoing PCI or coronary angiograph from October 2008 to March 2009 were enrolled in this study. Levels of serum creatinine, blood urine nitrogen and urine β2microglobulin were determined three days before and at 3, 7 days after coronary artery intervention. ResultAmong the 200 patients, 14 patients(7%) developed CIN.The incidence of preexisting renal dysfunction, hypertension, diabetes mellitus in CIN patients and in nonCIN patients did not significantly vary(P＜0.05). Age, body mass index(BMI), angiotensin converting enzyme inhibitors (ACEIs),　coronary arteriosclerosis, dosages of contrast agent and hyperlipemia did not significantly vary between the two groups (P＞0.05). Identified by regression, preexisting renal dysfunction and diabetes mellitus were independent risk factors of CIN. ConclusionsHypertension is one related risk factor of CIN, while age, BMI, ACEIs, coronary arteriosclerosis, dosages of contrast agent and hyperlipemia are not. Preexisting renal dysfunction and diabetes mellitus are independent risk factors of CIN.

Key words: Coronary artery angiography; Percutaneous coronary intervention; Contrastinduced nephropathy; Risk factors

中图分类号:

R692.5

. 冠状动脉介入诊疗术患者造影剂肾病的危险因素研究[J]. 山东大学学报(医学版), 2009, 47(10): 98-101.

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