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目的:观察缺血性卒中患者脑血管造影后对比剂相关急性肾损伤(CI-AKI)对住院死亡率及1年死亡率的影响。方法:回顾性纳入2009-01-01~2013-12-31在广东省人民医院接受脑血管造影介入术的缺血性脑卒中患者,收集患者造影前、造影过程中及造影后相关临床资料,通过多因素回归模型分析CI-AKI对住院死亡率及1年死亡率的影响。结果:共有1 820例接受脑血管造影的缺血性脑卒中患者纳入本研究,其中81例(4.5%)患者发生了CI-AKI。多因素Logistic回归模型显示脑血管造影后CI-AKI增加患者住院死亡风险(优势比OR=3.99;95%CI 1.43~11.14;P=0.008),同时多因素COX回归模型显示CI-AKI也是1年死亡的独立危险因素(风险比HR=1.96;95%CI 1.18~3.26;P=0.009)。结论:脑血管造影后CI-AKI是缺血性卒中患者住院死亡及1年死亡的独立危险因素,对接受脑血管造影患者采取有效措施预防CI-AKI十分必要。
Objective: To observe the effect of contrast-induced acute kidney injury (CI-AKI) on hospital mortality and 1-year mortality after cerebral angiography in patients with ischemic stroke. Methods: The clinical data of patients with ischemic stroke receiving cerebrovascular angiography interventional surgery at Guangdong Provincial People’s Hospital from January 2009 to January 31, 2013 were retrospectively collected. The clinical data of patients before and after contrast, The impact of CI-AKI on hospital mortality and 1-year mortality was analyzed by multivariate regression analysis. RESULTS: A total of 1 820 ischemic stroke patients undergoing cerebrovascular angiography were included in this study, and 81 (4.5%) patients developed CI-AKI. Multivariate logistic regression models showed that CI-AKI increased the risk of in-hospital mortality after cerebral angiography (odds ratio OR = 3.99; 95% CI 1.43 to 11.14; P = 0.008), while multivariate COX regression models also showed that CI-AKI was also 1 year Independent risk factors for death (hazard ratio HR = 1.96; 95% CI 1.18-3.26; P = 0.009). Conclusion: CI-AKI after cerebral angiography is an independent risk factor for in-hospital death and one-year death in patients with ischemic stroke. It is necessary to take effective measures to prevent CI-AKI in patients undergoing cerebral angiography.