吴浩龙, 萧杰明, 张美好. 急性心肌梗死病人急诊PCI后发生对比剂肾病的危险因素分析[J]. 蚌埠医科大学学报, 2018, 43(8): 1022-1025. DOI: 10.13898/j.cnki.issn.1000-2200.2018.08.013
    引用本文: 吴浩龙, 萧杰明, 张美好. 急性心肌梗死病人急诊PCI后发生对比剂肾病的危险因素分析[J]. 蚌埠医科大学学报, 2018, 43(8): 1022-1025. DOI: 10.13898/j.cnki.issn.1000-2200.2018.08.013
    WU Hao-long, XIAO Jie-ming, ZHANG Mei-hao. Risk factor analysis of contrast-induced nephropathy in AMI patients treated with emergence PCI[J]. Journal of Bengbu Medical University, 2018, 43(8): 1022-1025. DOI: 10.13898/j.cnki.issn.1000-2200.2018.08.013
    Citation: WU Hao-long, XIAO Jie-ming, ZHANG Mei-hao. Risk factor analysis of contrast-induced nephropathy in AMI patients treated with emergence PCI[J]. Journal of Bengbu Medical University, 2018, 43(8): 1022-1025. DOI: 10.13898/j.cnki.issn.1000-2200.2018.08.013

    急性心肌梗死病人急诊PCI后发生对比剂肾病的危险因素分析

    Risk factor analysis of contrast-induced nephropathy in AMI patients treated with emergence PCI

    • 摘要: 目的:探讨急性心肌梗死病人急诊经皮冠状动脉介入治疗(PCI)后发生对比剂肾病(CIN)的危险因素。方法:选取110例行急诊PCI治疗的急性心肌梗死病人,按是否出现CIN,将其分为CIN组和非CIN组,比较2组病人对比剂剂量(CMV)、基础疾病、术前用药情况、一般资料等,分析CIN的相关危险因素。结果:2组病人在肾脏替代治疗、中风、输血、心绞痛、死亡等事件上差异均无统计学意义(P>0.05)。比较住院期间2组病人不良事件发现,CIN组机械通气、急性心力衰竭、主动脉球囊反搏辅助和心率失常均高于非CIN组(P<0.05~P<0.01)。CIN组在血糖、超敏C反应蛋白(hs-CRP)、肌酸激酶峰值、贫血、血肌酐(Scr)、CMV等方面均明显高于非CIN组(P<0.01),在肾小球滤过率(eGFR)、血红蛋白、左心室射血分数(LVEF)低于非CIN组(P<0.05~P<0.01)。多因素分析显示,CMV、肾功能不全、Scr、LVEF、eGFR、糖尿病、贫血、hs-CRP以及CMV/eGFR比值均为CIN发生的危险因素(P<0.05~P<0.01)。结论:对急性心肌梗死病人进行急诊PCI治疗时,要严格控制病人的CMV、肾功能不全、Scr、LVEF、eGFR、糖尿病、贫血、hs-CRP以及CMV/eGFR比值,以减少CIN的发生。

       

      Abstract: Objective:To investigate the risk factors of contrast-induced nephropathy(CIN) in acute myocardial infarction(AMI) patients treated with emergence percutaneous coronary intervention(PCI).Methods:One hundred and ten AMI patients treated with emergency PCI were divided into the CIN group and non-CIN group.The drug dosage,basic disease,preoperative medication and general data between two groups were compared,and the related risk factors of CIN were analyzed.Results:The differences of the renal replacement therapy,stroke,blood transfusion,angina and death between two groups were not statistically significant(P>0.05).During hospitalization,the mechanical ventilation,acute heart failure,aortic balloon pacing assistance,and arrhythmias in CIN group were higher than those in non-CIN group(P<0.05 to P<0.01).The blood glucose,hypersensitive C-reactive protein(hs-CRP),creatinine kinase peak value,anemia,serum creatinine(Scr) and contrast dose (CMV) in CIN group were significantly higher than those in non-CIN group(P<0.05 to P<0.01).The glomerular filtration rate(eGFR),hemoglobin,left ventricular ejection fraction (LVEF) in CIN group were lower than those in non-CIN group(P<0.05 to P<0.01).Multivariate analysis results showed that the CMV,renal insufficiency,Scr,LVEF,eGRF,diabetes,anemia,hs-CRP and ratio of CMV/eGFR were the risk factors of the occurrence of CIN(P<0.05 to P<0.01).Conclusions:The CMV,renal insufficiency,Scr,LVEF,eGRF,diabetes,anemia,hs-CRP and ratio of CMV/eGFR in AMI patients treated with emergence PCI should be strictly controlled to decrease the occurrence of CIN.

       

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