老年糖尿病肾病患者造影剂肾病的危险因素及预防措施分析.docVIP

剂^^因咖鯛髄 分析 2018-03-29 10:29:48中国现代医生2018年5期 夏奇奂陈群杜斌卢跃 ［摘要］戸的 探討老年糖球病肾病患者造影剂肾病(contrast induced nephropathy, CIN)的危 险因素及其预防措施。方法 选取2016年8月?2017年4月期间我院收治的220例老年糖尿病患者 作为研究对象，全部病例均行PCI术及冠脉造影检查，依据是否存在造影剂肾病展开分组，将不存在 造影剂肾病80例患者作为对照组，将发生造影剂肾病的140例患者作为观察组，分析造影剂肾病的 危险因素，进而制定有效的预防措施。结果(1)两组在住院天数上对比差异显著，在空腹血糖、 甘油三酯等指标上对比无明显差异(P0.05)o (2)单因索分析：CIN受到BMI(t=3.564, P=0.016). 肾小球滤过率(t二5.846, PO.OOO)、血清肌Hf (t=3.846, P=0.038) 存在慢性肾病(x2=4.587, P=0.015).住院天数(t=5.241, P=0.001) 造影剂剂量(t=7.454, P=0.000) ACER(x2=7.454, P=0.000)、糖尿病视网膜病变(X2=4.541, P=0.019)、大动脉病变 02二3.854, P二0.035)、心 肌梗死(x2=5.246, P=0.000)等因素影响，与血清胱抑素C水平、载脂蛋白A、尿酸等因素无关。 多因索分析：肾小球滤过率(e-GFR)、存在慢性肾病、ACER三者是CIN发生的独立危险因 素。结论CIN受到存在慢性肾病、造影剂剂量等因素影响，应针对危险因素制定有效预防措施。 ［关键词］老年糖尿病肾病患者；造影剂肾病；危险因素；预防措施 ［中图分类号］R587.1 ［文献标识码］B ［文章编号］1673-9701 (2018) 05-0082-04 ［Abstract］ Objective To explore the risk factors of contrast-induced nephropathy (CIN) in elderly patients with diabetic nephropathy and its preventive measures. Methods A total of 220 elderly diabetic patients admitted in our hospital from August 2016 to April 2017 were enrolled in this study. All patients underwent PCI and coronary angiography. The patients were grouped according to the presenee or absenee of contrast induced nephropathy.80 patients without contrast induced nephropathy were selected as control group, and 140 patients with contrast-induced nephropathy were chosen as the observation group. The risk factors for contrast induced nephropathy were analyzed and then the effective preventive measures were developed. Results There was a significant difference between the two groups in the number of hospital days. There was no significant difference in the indicators such as fasting blood glucose, triglyceride (P0.05). (2) Univariate analysis： after univariate analysis, CIN was affected by BMI (3.564, P=0.016), glomerular filtration rate(t=5.846, P=0.000), serum creatinine (t=3.846, P=0.038), the presence of chronic kidney disease(x2=4.587, P=0.015) , hospitalization time (t=5