Abstract:ObjectiveTo investigate the incidence of contrast-induced nephropathy(CIN) in patients undergoing percutaneous coronary intervention(PCI) and assess the predictive role of the ratio of contrast medium volume to estimated glomerular filtration rate (CMV/eGFR) in super-elderly diabetic patients undergoing elective PCI who developed CIN.MethodsEight hundred and seventy-five PCI patients were retrospectively collected in Affiliated Hospital of Jining Medical University.Patients were divided into CIN group and non-CIN group based on the presence of CIN.Date of the two groups were compared concerning sex,age,smoking,hypotension,LVEF,hemoglobin,LDL-C,glucose,history of hypertension and type 2 diabetes,serum creatinine and eGFR pre-PCI,serum creatinine and eGFR post 48h-PCI.Risk factors for CIN were analyzed by logistic regression statistical model.ResultsAmong eight hundred and seventy-five patients,fortytwo patients experienced CIN (4.8%).The disease incidence of male,hypertention,type 2 diabetes,hyperlipidemia,smoking,hypotentino,anemia,myocardial infarction with shock was 65.71%,54.86%,37.26%,22.51%,34.17%,16.80%,4.20%,8.91%,respectively.In the other two groups,the patients with the super-elderly (age≥70y) (33.33%,19.33%,χ2=4.902,P<0.05),type 2 diabetes(52.38%,36.49%,χ2=4.317,P=0.05),smoking(50.00%,33.37%,χ2=4.914,P<0.05),with hypotention(28.57%,16.21%,χ2=4.374,P<0.05), myocardial infarction combined with shock(19.05%,8.40%,χ2=5.579,P<0.05),LVEF[(36.46±9.27)%,(43.62±3.46)%,t=2.398,P<0.05],and larger contrast medium volume[(154.5±95.3)mL,(115.04±49.63)mL,t=2.069,P<0.05] were proned to CIN.eGFR was lower in CIN[(72.50±15.06)ml/(min·1.73m2),(108.55±21.7)ml/(min·1.73m2),t=7.220, P<0.05].There were significant differences between the two group in CMV/eGFR[(2.19±1.30),(1.01±0.40),t=-3.439,P<0.05].Logistic regression analysis showed that age ≥70y(RR=5.27,P<0.05), type 2 diabetes(RR=9.87,P<0.05),LVEF(RR=7.35,P<0.05),pre-PCI eGFR(RR=4.12,P<0.05),myocardial infarction with shock(RR=6.75,P<0.05),CMV/eGFR(RR=13.45,P<0.05)were the risk factors for CIN. ROC analysis indicated that a CMV/eGFR of more than 1.5 was a predictor of CIN.The sensitivity and specificity for CIN of CMV/eGFR of more than 1.5 was 72.50% and 84.00%,respectively.ConclusionsIt is very important to estimate risk factors of patients before PCI.The superelderly diabetic patients are proned to CIN.The CMV/eGFR ratio could be a valuable predictor for CIN in superelderly diabetic patients after elective PCI.
刘雷 石莉 张宜明 王彦富 李新建 李清贤. 造影剂剂量与估计肾小球滤过率比值对高龄糖尿病患者造影剂肾病的诊断价值[J]. 中华诊断学电子杂志, 2014, 2(4): 279-284.
Liu Lei,Shi Li,Zhang Yiming,Wang Yanfu,Li Xinjian,Li Qingxian. The diagnostic value of the ratio of contrast medium volume to estimated glomerular filtration rate in contrast-induced nephropathy diabetics patients. zhzdx, 2014, 2(4): 279-284.
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