CAJ | 학술논문

目的：探讨脑血管介入术后对比剂致急性肾损伤（CI-AKI）的相关危险因素。方法回顾性分析2005年1月—2013年12月广东省人民医院神经内科和神经外科进行脑血管造影介入术的5423例患者的临床资料，对行脑血管造影介入术患者进行评估和筛选，建立临床病史资料数据库。入选患者均使用等渗对比剂碘克沙醇。以发生CI-AKI为观察终点，将患者分为CI-AKI组和非CI-AKI组。采用多因素Logistic回归模型对与CI-AKI发生相关的危险因素进行分析。结果共入选4164例患者，其中137例发生CI-AKI，发生率为3.3％。多因素Logistic回归分析结果显示，年龄＞60岁（OR＝1.965，95％CI：1.244～3.136）、基线估算肾小球滤过率（eGFR）＜60 ml／（min·1.73 m2）（OR ＝4.163，95％ CI：2.422～5.873）、糖尿病（OR ＝3.140，95％ CI：1.983～3.902）、贫血（OR＝1.524，95％CI：1.226～3.253）是脑血管造影介入术后发生 CI-AKI的危险因素。结论慢性肾脏病[eGFR＜60 ml／（min·1.73 m2）]、糖尿病、贫血、老年（年龄＞60岁）是脑血管造影介入术后发生CI-AKI的独立危险因素。
목적：탐토뇌혈관개입술후대비제치급성신손상（CI-AKI）적상관위험인소。방법회고성분석2005년1월—2013년12월광동성인민의원신경내과화신경외과진행뇌혈관조영개입술적5423례환자적림상자료，대행뇌혈관조영개입술환자진행평고화사선，건립림상병사자료수거고。입선환자균사용등삼대비제전극사순。이발생CI-AKI위관찰종점，장환자분위CI-AKI조화비CI-AKI조。채용다인소Logistic회귀모형대여CI-AKI발생상관적위험인소진행분석。결과공입선4164례환자，기중137례발생CI-AKI，발생솔위3.3％。다인소Logistic회귀분석결과현시，년령＞60세（OR＝1.965，95％CI：1.244～3.136）、기선고산신소구려과솔（eGFR）＜60 ml／（min·1.73 m2）（OR ＝4.163，95％ CI：2.422～5.873）、당뇨병（OR ＝3.140，95％ CI：1.983～3.902）、빈혈（OR＝1.524，95％CI：1.226～3.253）시뇌혈관조영개입술후발생 CI-AKI적위험인소。결론만성신장병[eGFR＜60 ml／（min·1.73 m2）]、당뇨병、빈혈、노년（년령＞60세）시뇌혈관조영개입술후발생CI-AKI적독립위험인소。
Objective To investigate the related risk factors of contrast-induced acute kidney injury (CI-AKI)after cerebrovascular intervention. Methods The clinical data of 5423 patients performed cerebrovascular angiography and intervention at the Departments of Neurology and Neurosurgery,Guangdong People′s Hospital from January 2005 to December 2013 were analyzed retrospectively. The patients who underwent cerebrovascular angiography and intervention were evaluated and screened. A clinical history database was established. All the selected patients used iodixanol,an isotonic contrast agent. The occurrence of CI-AKI was used as an endpoint. The patients were divided into either a CI-AKI group or a non CI-AKI group. A multivariate Logistic regression model was used to analyze the risk factors associated with the occurrence of CI-AKI. Results A total of 4164 patients were finally enrolled,including 137 had CI-AKI. The incidence of CI-AKI was 3. 3%. The results of multivariate Logistic regression showed that age >60 years (OR,1. 965,95%CI 1. 244-3. 136),baseline estimated glomerular filtration rate (eGFR)<60mL/(min·1. 73 m2)(OR,4. 163,95%CI 2. 422-5. 873),diabetes (OR,3. 140,95%CI 1. 983-3. 902),and anemia (OR,1. 524,95%CI 1. 226 -3. 253)were the influencing factors for occurring CI-AKI after cerebrovascular angiography and intervention. Conclusion Chronic kidney disease (eGFR<60 mL/[min·1. 73 m2 ]),diabetes,anemia,and old age (age >60 years)are the independent risk factors for occurring CI-AKI after cerebrovascular angiography and intervention.