糖尿病患者冠状动脉介入治疗术后对比剂肾病的危险因素及预后分析

张善稳; 曲小龙; 孟璟; 胡厚源

doi:10.13406/j.cnki.cyxb.000815

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糖尿病患者冠状动脉介入治疗术后对比剂肾病的危险因素及预后分析

心血管、呼吸疾病 | 更新时间：2024-01-17

- 糖尿病患者冠状动脉介入治疗术后对比剂肾病的危险因素及预后分析
- Risk factors of contrast-induced nephropathy in patients with diabetes after percutaneous coronary intervention and its prognosis
- 重庆医科大学学报 2016年41卷第4期页码：341-346
- 作者机构：
  
  第三军医大学附属第一医院心血管内科
- 作者简介：
- 基金信息：
  
  中国心血管医师研究基金资助项目（编号:CV-fund,2013-10）
- DOI：10.13406/j.cnki.cyxb.000815
  中图分类号： R541.4;R587.1
- 纸质出版日期：2016，
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[1]张善稳,曲小龙,孟璟,胡厚源.糖尿病患者冠状动脉介入治疗术后对比剂肾病的危险因素及预后分析[J].重庆医科大学学报,2016,41(04):341-346.

Zhang Shanwen, Qu Xiaolong, Meng Jing, et al. Risk factors of contrast-induced nephropathy in patients with diabetes after percutaneous coronary intervention and its prognosis[J]. Journal of Chongqing Medical University, 2016,41(4):341-346.
[1]张善稳,曲小龙,孟璟,胡厚源.糖尿病患者冠状动脉介入治疗术后对比剂肾病的危险因素及预后分析[J].重庆医科大学学报,2016,41(04):341-346. DOI： 10.13406/j.cnki.cyxb.000815.

Zhang Shanwen, Qu Xiaolong, Meng Jing, et al. Risk factors of contrast-induced nephropathy in patients with diabetes after percutaneous coronary intervention and its prognosis[J]. Journal of Chongqing Medical University, 2016,41(4):341-346. DOI： 10.13406/j.cnki.cyxb.000815.

摘要

目的:探讨糖尿病患者经皮冠状动脉介入治疗（percutaneous coronary intervention

PCI）术后对比剂肾病（contrast-induced nephropathy

CIN）的危险因素和预后。方法:回顾性分析2009年1月至2013年5月于我院行PCI的1 481例冠心病患者的临床资料

分为糖尿病组（n=375）和非糖尿病组（n=1 106）。观察2组患者PCI术后肾功能变化及CIN发生率

分析糖尿病患者PCI术后CIN发生的危险因素及预后。结果:PCI术后非糖尿病组胱抑素C（cystatin C

CysC）和血清肌酐（serum creatinine

Scr）水平显著低于糖尿病组（P<0.05）;肾小球滤过率估计值（estimated glomerular filtration rate

e GFR）水平明显高于糖尿病组（P<0.05）。糖尿病组和非糖尿病组CIN发生率分别为36.8%和16.0%（P<0.001）。多因素Cox回归分析显示

高血压、心衰、贫血、袢利尿剂、肾功能不全、术前GFR、对比剂用量和术前口服二甲双胍是糖尿病患者PCI术后CIN发生的独立危险因素（P<0.05）。Kaplan-Meier生存分析显示CIN组两年生存率明显低于非CIN组（P<0.001）。结论:糖尿病患者PCI术后CIN发生率高且生存率明显下降

其危险因素包括高血压、心衰、贫血、袢利尿剂、肾功能不全、术前GFR、对比剂用量和术前口服二甲双胍。

Abstract

Objective:To analyze the risk factors and the prognosis of contrast-induced nephropathy(CIN)in patients with diabetes after percutaneous coronary intervention(PCI). Methods:A retrospective study including 1481 cases with coronary heart disease underwent PCI in our hospital from January 2009 to May 2013 was conducted. All the cases were divided into diabetic group(n=375)and non-diabetic group(n=1106). The change of renal function and the incidence of CIN were observed after PCI. The risk factors and prognosis of CIN in patients with diabetes after PCI were analyzed. Results:The cystatin C(CysC) and serum creatinine(Scr)concentrations were lower in non-diabetic group than in diabetic group after PCI(P<0.05). The estimated glomerular filtration rate(e GFR)was significantly higher in non-diabetic group than in diabetic group after PCI(P<0.05). The incidence of CIN in diabetic group and non-diabetic group were 36.80%(138/375) and 16.00%(177/1106)

respectively(P <0.001). Multivariate Cox regression analysis demonstrated that some factors(such as hypertension

heart failure

systolic pressure

hemoglobin

loop diuretic

renal insufficiency

preoperative e GFR

volume of contrast-medium and oral metformin before operation) were independent factors of the occurrence of CIN in patients with diabetes after PCI. Kaplan-Meier survival analysis showed that the two-year survival in CIN group was significantly lower than that of non-CIN group(P<0.001). Conclusion:After PCI in patients with diabetes

the incidence of CIN is higher than that patients without diabetes

and survival rate significantly is decreased after CIN. The risk factors in that patients include hypertension

heart failure

anemia

loop diuretic

renal insufficiency

preoperative e GFR

volume of contrast-medium and metformin before PCI.

关键词

糖尿病经皮冠状动脉介入治疗对比剂肾病危险因素预后

Keywords

diabetespercutaneous coronary interventioncon trast-induced nephropathyrisk factorsprognosis

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