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目的:了解冠心病患者行冠状动脉造影术前后肾功能检查和造影剂使用情况。方法:回顾性调查行冠状动脉造影术冠心病患者的基础疾病、造影剂类型及用量、肾功能检查情况、合并用药等情况,对比发生造影剂肾病(CIN)及未发生CIN患者的临床特点,并对相关危险因素进行分析。结果:共调查行冠状动脉造影术的冠心病患者188例,男132例(70.2%),女56例(29.8%);平均年龄(60.41±9.68)岁,大于75岁的病例有18例(9.6%)。合并基础疾病最多是高血压、心功能不全、糖尿病;使用造影剂主要是碘海醇,平均用量(139.98±81.82)ml。所有患者术前均检查肾功能,术后复查肾功能者54例(28.7%),其中3例发生CIN。CIN患者糖尿病病例数、造影剂用量与未发生CIN患者相比差异有统计学意义(P<0.05);CIN患者的内生肌酐清除率也低于正常组,但差异无统计学意义(P>0.05)。未复查肾功能患者部分存在发生CIN的一种或多种危险因素。结论:冠心病患者多存在至少一种发生CIN的危险因素,行冠状动脉造影术应提高警惕,造影术后复查肾功能的意识有待加强。
OBJECTIVE: To understand the renal function tests and contrast media before and after coronary angiography in patients with coronary heart disease. Methods: The clinical data of patients with coronary heart disease (CHD) undergoing coronary angiography (CAG) and coronary heart disease (CHD) were retrospectively reviewed. The clinical features, such as contrast-induced nephropathy (CIN) And analyze the relevant risk factors. Results: A total of 188 coronary heart disease patients undergoing coronary angiography were investigated, including 132 males (132.2%) and 56 females (29.8%), with a mean age of (60.41 ± 9.68) years and 18 years 9.6%). The most common underlying diseases were hypertension, cardiac insufficiency and diabetes. The contrast agent was mainly iohexol, with an average amount of 139.98 ± 81.82 ml. All patients were examined before renal function, postoperative renal function in 54 cases (28.7%), of which 3 cases of CIN. The number of diabetic patients and the amount of contrast medium in CIN patients were significantly different from those without CIN (P <0.05). The creatinine clearance rate in CIN patients was also lower than that in normal patients (P> 0.05). One or more risk factors for developing CIN exist in part of patients who have not reviewed renal function. Conclusion: There are at least one risk factor of CIN in coronary heart disease patients. CABG should be vigilant and the consciousness of renal function review after angiography should be strengthened.