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目的探讨冠状动脉造影后发生造影剂肾病(RCIN)的临床相关因素及术前水化的作用。方法回顾性分析2006年8月至2008年8月解放军总医院住院行冠状动脉造影患者279例,其中肾功能不全者给予水化,比较临床特点、造影当日静脉液体入量和造影前后血清肌酐的变化。结果RCIN总发生率6.81%(19/279),高血压患者中RCIN发生率为8.65%(16/185),糖尿病患者中RCIN发生率为12.1%(12/99),肾功能不全患者中RCIN发病率为0。多因素Logistic回归分析显示,与发生RCIN相关的因素分别是年龄、糖尿病、造影当日静脉补液量,与性别、吸烟、高血压、冠心病、肾功能不全无关。结论60岁以上人群RCIN的发生率较高,可能与肾脏储备能力降低有关;术前充分水化是减少RCIN发生的有效办法。
Objective To investigate the clinical correlative factors of RCIN after coronary angiography and the effect of preoperative hydration. Methods A retrospective analysis of 279 patients with coronary artery angiography admitted to PLA General Hospital from August 2006 to August 2008 was performed. Among them, renal dysfunction was given hydration. The clinical features, the amount of venous fluid during angiography and serum creatinine before and after angiography Variety. Results The overall incidence of RCIN was 6.81% (19/279). The incidence of RCIN was 8.65% (16/185) in patients with hypertension. The incidence of RCIN was 12.1% (12/99) in patients with diabetes mellitus, and RCIN in patients with renal insufficiency The incidence is 0. Multivariate logistic regression analysis showed that the factors associated with the occurrence of RCIN were age, diabetes mellitus, intravenous fluid volume on the day of angiography, and sex, smoking, hypertension, coronary heart disease, renal insufficiency. Conclusions The incidence of RCIN in people over 60 years old may be related to the decrease of renal reserve capacity. Preoperative hydration is an effective way to reduce the occurrence of RCIN.