Analysis of the incidence and influencing factors of acute contrast induced renal injury after emergency PCI
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摘要: 目的:探讨急诊PCI术后造影剂相关性急性肾损伤(CI-AKI)发生情况及其影响因素。方法:选择2018年3月-2020年4月期间我院行冠状动脉造影及急诊PCI治疗的急性冠脉综合征患者294例进行研究。收集可能引起CI-AKI的影响因素,在单因素分析基础上行多因素Logistic回归分析以判断各因素对患者CI-AKI的综合影响。结果:本次调查的294例患者中共出现34例(11.56%)CI-AKI,单因素基础上多因素分析结果显示:有糖尿病史(OR=1.449,95%CI:1.043~2.014)、低密度脂蛋白高于正常值(OR=1.502,95%CI:1.045~2.159)、eGFR<60 mL/(min·1.73 m2)(OR=1.426,95%CI:1.008~2.018)、左心室射血分数<55%(OR=1.416,95%CI:1.017~1.972)、造影剂接触时间延长(OR=1.426,95%CI:1.053~1.932)为急诊PCI术后CI-AKI的危险因素(P<0.05)。本研究对各因素乘积进行分析显示各因素间无交互作用(P>0.05)。结论:急诊PCI术后CI-AKI的发生率较高,其主要受患者糖尿病史、低密度脂蛋白胆固醇、基线eGFR、左心室射血分数、造影剂接触时间的影响,临床上可通过加强对上述指标的监测以早期筛查出高危患者。
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关键词:
- 经皮冠状动脉介入治疗 /
- 造影剂相关性急性肾损伤 /
- 影响因素 /
- 急诊
Abstract: Objective: To explore the occurrence and influencing factors of contrast-induced acute kidney injury(CI-AKI) after emergency PCI.Methods: Two hundred and ninty-four patients with acute coronary syndrome who underwent coronary angiography and emergency PCI treatment in our hospital from March 2018 to April 2020 were enrolled for the study. Collect the influencing factors that may cause CI-AKI, and perform multi-factor Logistic regression analysis on the basis of univariate analysis to determine the comprehensive influence of each factor on the patient's CI-AKI.Results: A total of 34(11.56%) CI-AKI occurred in the 294 patients investigated in this survey.The results of multivariate analysis on a single factor basis showed that the history of diabetes(OR=1.449, 95%CI:1.043-2.014), low-density lipoprotein(OR=1.502, 95%CI:1.045-2.159), baseline eGFR<60 mL/(min·1.73 m2)(OR=1.426, 95%CI:1.008-2.018), left ventricular ejection fraction <55%(OR=1.416, 95%CI:1.017-1.972), contrast medium exposure time was prolonged(OR=1.426, 95%CI:1.053-1.932) were the risk factor for CI-AKI after emergency PCI(P<0.05). In this study, the analysis of the product of each factor showed that there was no interaction between the factors(P>0.05).Conclusion: The incidence of CI-AKI after emergency PCI is high, which is mainly affected by the history of diabetes mellitus, low-density lipoprotein cholesterol, baseline eGFR, left ventricular ejection fraction, contrast medium contact time. In clinical, we can strengthen the monitoring of the above indicators to screen out the high-risk patients in the early stage. -
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