| 余云华,何蓉蓉,于亚梅,李 然,鲍礼智,姜梦妮,郑 兴.冠心病患者PCI术后对比剂肾病发生的预测因素的临床研究[J].,2017,17(12):2328-2331 |
| 冠心病患者PCI术后对比剂肾病发生的预测因素的临床研究 |
| Risk Factors of Contrast Media Induced Nephropathy in Elder Patients with Coronary Heart Disease after Percutaneous Coronary Intervention |
| 投稿时间：2016-10-29 修订日期：2016-11-23 |
| DOI：10.13241/j.cnki.pmb.2017.12.032 |
| 中文关键词: PCI术后 对比剂肾病 CIN风险评分系统 预测因子 |
| 英文关键词: Postoperative of PCI CIN MRS Predictive factors |
| 基金项目:上海市科委科技支撑项目（13411950302） |
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| 中文摘要: |
| 摘要 目的：探讨冠心病患者PCI术后发生对比剂肾病（Contrast Media Induced Nephropathy, CIN）的预测因素。方法：入选2015年1月至2015年9月长海医院确诊为冠心病并接受PCI治疗的≥75岁老年患者共计317例，根据CIN评分分成CIN评分低分组（4-10分）、CIN评分中分组（11-16分）、CIN评分高分组（≥16分），分析比较不同CIN评分组患者的术后对比剂肾病的发生情况；对相关危险因素进行单因素及多因素分析，探讨冠心病PCI患者发生对比剂肾病的独立预测因子。结果：317例冠心病PCI患者中，14例发生CIN（4.4 %），CIN评分高分组比例最高（4例，11.8 %，P=0.042）。单因素分析表明，CIN风险评分、术前GFR、术前肌钙蛋白、术前总胆固醇、急性心肌梗死、Syntax评分在术后CIN发生中存在显著的统计学差异（P<0.05），为独立的风险预测因素。多因素Logistic回归分析结果显示，CIN风险评分在术后CIN发生中存在显著的统计学差异（95%CI:1.37-7.78 , P<0.05）,术前GFR在术后CIN发生中存在显著的统计学差异（95%CI:1.01-1.07P<0.05）,两者均为独立预测因子。结论：CIN风险评分、术前GFR是高龄冠心病患者PCI术后发生CIN的独立预测因子。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the predicative factors for Contrast Induced Nephropathy（CIN）. Methods: The study analysed the total of 317 patients who were diagnosed with coronary heart disease (CHD) and accept the PCI therapy between January 2015 and September 2015 in Changhai hospital. The patients were divided into low score group (4-10 points), moderate group (11-16 points), high score group(≥16 points) according to CIN scores. We analyzed and compared the incidence of postoperative contrast induced nephropathy in patients with different CIN scores. Single and multiple factor analyses were used to investigate the independent risk factors for the development of CIN within CHD patients accepted the PCI therapy. Results: Among the 317 CHD cases,14 cases had CIN and the incidence was 4.4 %, and the highest proportion of CIN was the high score group（4cases, 11.8 %, P=0.042）. Single factor analysis showed that the CIN MRS, preoperative GFR, preoperative cTNI, preoperative CHOL, AMI, Syntax-score were the independent risk predictors of postoperative CIN（P<0.05）. Multiple factor analysis showed that the CIN MRS significantly increased the risk of postoperative CIN（95 %CI: 1.37-7.78 , P<0.05）, and so did the preoperative GFR（95 %CI: 1.01-1.07, P <0.05）. Both of them were independent predictive factors of CIN. Conclusion: CIN MRS and preoperative GFR were the independent predictive factors of CIN. |
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