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。
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 nonCIN 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,e GRF,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,e GRF,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.
作者
吴浩龙
萧杰明
张美好
WU Hao-long;XIAO Jie-ming;ZHANG Mei-hao(Departlnent of Cardiology;Departlnent of Emergency,Zengcheng District People＇s Hospital of Guangzhou,Guangzhou Guangdong 440100,China)
出处
《蚌埠医学院学报》
CAS
2018年第8期1022-1025,共4页
Journal of Bengbu Medical College
关键词
对比剂肾病
经皮冠状动脉介入治疗
血糖
超敏C反应蛋白
肾小球滤过率
contrast-induced nephropathy
percutaneous coronary intervention
blood glucose
hypersensitive C-reactive protein
glomerular filtration rate
