【摘要】 目的:应用ESUR和KDIGO标准评价血管造影患者碘造影剂急性肾损伤(contrast-induced acute kidney injury,CI-AKI)的发生率、危险因素及预后。方法:选择2011年4月至2012年1月在中南大学湘雅二医院行血管造影或(和)介入治疗的患者260例,所有患者均使用低渗对比剂碘佛醇。造影前及造影后48,72 h抽血检测SCr水平。多因素logistic回归分析影响CI-AKI发生的危险因素。追踪随访造影剂使用后1年内的主要不良事件。结果:260例患者中,符合ESUR标准的CI-AKI患者23例,CI-AKI的发生率为8.8%;符合KDIGO标准的CI-AKI患者12例,CI-AKI的发生率为4.6%。多因素logistic回归分析显示:应用ESUR标准,糖尿病和脱水是CI-AKI发生的独立危险因素;应用KDIGO标准,慢性肾脏病、高胆固醇血症、糖尿病是CI-AKI发生的独立危险因素。预后研究表明:CI-AKI患者的死亡率明显高于非CIAKI患者(P<0.05)。结论:CI-AKI的发生率与诊断标准的选择有关;糖尿病、慢性肾脏病、脱水、高胆固醇血症是介入诊疗患者CI-AKI发生的独立危险因素。CI-AKI是介入诊疗患者造影后1年内死亡相关的原因之一。更多还原

【Abstract】 Objective: To investigate the incidence, risk factors and prognosis for contrast-induced acute kidney injury(CI-AKI) according to ESUR and KDIGO criteria in patients undergoing angiography. Methods: We evaluated 260 patients undergoing angiography and/or intervention therapy from April 2011 to January 2012 in the Second Xiangya Hospital of Central South University. All patients received low-osmolality contrast agent(ioversol). Serum creatinine was measured before angiography or at 48 or 72 h after procedure. The multivariate logistic regression was used to analyze the risk factors of CI-AKI. The major adverse events were observed in a year of follow-up. Results: Among the 260 patients, 23 experienced CI-AKI and the incidence was 8.8% according to ESUR criteria. Twelve patients experienced CI-AKI and the incidence was 4.6% according to KDIGO criteria. The multivariate logistic regression analysis showed that diabetes mellitus and dehydration were the independent risk factors for CI-AKI according to ESUR criteria; In another KDIGO criteria, chronic kidney disease(CKD), hypercholesterolemia and diabetes mellitus were the independent risk factors for CI-AKI. The prognosis study showed that the mortality of patients with CI-AKI were significantly higher than those without CI-AKI(P<0.05). Conclusion: The incidence of CI-AKI is associated with diagnostic criteria. Diabetes mellitus, CKD, dehydration and hypercholesterolemia were the independent risk factors for CI-AKI. CI-AKI is a relevant factor for mortality in a year after angiography and/or intervention therapy.更多还原