摘要
目的：探讨经皮冠状动脉介入治疗（PCI）术后发生对比剂肾病（CIN）患者的近远期疗效。方法选择2009年7月至2014年4月沈阳军区总医院心内科收治的PCI术后发生CIN的患者43例，收集其基线资料、住院情况，并对其临床特征、危险因素、冠状动脉造影特点进行分析。结果43例患者PCI术后发生CIN，平均年龄（63.7±10.5）岁，其中男32例（74.4%），急性心肌梗死19例（44.2%）。术中共植入支架77枚，平均长度（26.3±6.2）mm，平均直径（3.1±0.5） mm，平均住院时间（10.7±6.4）d。术后平均随访（40.0±23.5）个月，随访率93.0%（40/43），14例（35.0%）患者死亡，其中近期死亡9例（22.5%）（包括心源性死亡7例，急性支架内血栓形成、急性肾衰竭各1例），远期死亡5例（12.5%），其中全因死亡4例（多脏器功能衰竭2例，恶性肿瘤2例），心源性死亡1例。结论 PCI术后发生CIN的患者通常合并多种疾病，不仅显著延长患者住院时间，增加住院期间死亡率，而且近期和远期疗效相对较差。因此临床医师要慎重，及时、尽早发现这类患者，并给予积极治疗，进一步改善预后。
ObjectiveTo investigate the short and long term efficacy of the patients who accured contrast-induced nephropathy （CIN） after accepting the percutaneous coronary intervention （PCI）. Methods The baseline features,risk factors,clinical characteristics and coronary angiography features were retrospectively analyzed.Results 43 patients after PCI occurred CIN,the mean age of all patients were （63.7±10.5） years,and 32 patients （74.4%） were male.All patients were treated with drug-eluting stent implantation and the total number of stents were 77.The average length were （26.3±6.2） mm and the mean diameter were （3.1±0.5） mm respectively.The average length of hospital stay was （10.7±6.4） days.The mean follow-up months were （40.0±23.5）.And the follow-up rate was 93.0% （40/43）.14 cases （35.0%） patients died,including the recent death of 9 cases （22.5%） （including cardiac death,acute stent thrombosis,acute renal failure） and the long-term death were five cases （12.5%）.Conclusions CIN patients after PCI usually accompany with varieties of diseases, not only significantly prolong hospital stays,but also increase mortality during hospitalization.Therefore,clinicians should be careful,timely and early to discover these patients,and give them active treatment in order to improve the further prognosis.
出处
《中国临床实用医学》
2015年第6期3-6,共4页
China Clinical Practical Medicine
基金
国家科技重大专项课题（2012zx09303016-002）：辽宁省科技攻关项目（2013225089）
关键词
急性冠状动脉综合征
经皮冠状动脉介入治疗
对比剂肾病
预后
Acute coronary syndrome
Percutaneous coronary intervention
Contrast-induced nephropathy
Prognosis
