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目的:探讨冠状动脉介入治疗(PCI)术后对比剂肾损伤(CIN)发病情况及危险因素。方法:回顾性调查天津市胸科医院心内科2009-01-2010-12行PCI术的1 435例患者,根据是否发生CIN将其分为CIN组和非CIN组,比较2组之间相关因素的差异,应用Logistic回归分析确定CIN的危险因素。结果:1 435例患者中有211例发生CIN,发病率为14.7%;CIN组和非CIN组间年龄、红细胞计数、血红蛋白含量、贫血、血压、左室射血分数(LVEF)、肾小球滤过率(GFR)、对比剂用量等均差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示,年龄>70岁、糖尿病、低血压、贫血、LVEF≤45%、GFR≤60ml/(min.1.73m2)、对比剂用量>200ml、心肌梗死、急诊PCI是CIN的危险因素。结论:CIN是PCI术后较常见的并发症,对具备CIN高危因素的患者,临床医生应高度重视。
Objective: To investigate the incidence and risk factors of contrast-induced renal injury (CIN) after coronary artery interventional therapy (PCI). METHODS: A retrospective survey of 1,433 patients undergoing PCI at the Department of Cardiology, Tianjin Chest Hospital, 2009-01-2010-12 was divided into CIN group and non-CIN group according to whether CIN occurred or not, and the correlation between the two groups was compared Logistic regression analysis was used to determine the risk factors for CIN. Results: CIN was found in 211 out of 1 435 cases, with an incidence rate of 14.7%. Age, red blood cell count, hemoglobin, anemia, blood pressure, left ventricular ejection fraction (LVEF) Filtration rate (GFR), contrast agent dosage were all statistically significant difference (all P <0.05). Multivariate logistic regression analysis showed that the risk of myocardial infarction and emergency PCI was CIN when they were over 70 years old, with diabetes, hypotension and anemia, LVEF≤45%, GFR≤60ml / (1.73m2), contrast agent dosage> 200ml factor. Conclusion: CIN is a more common complication after PCI. Clinicians should attach great importance to patients with CIN risk factors.