摘要
目的测定老年患者行增强CT前老年患者高敏C反应蛋白的水平,探讨老年患者增强CT后发生造影剂肾病的相关研究及预后价值。方法将2016年6月~2017年10月期间我院心内科收治的400例拟行冠脉增强CT的老年患者作为临床研究对象。根据术前检查高敏C反应蛋白的水平,将患者分为三组,A组(高敏C反应蛋白水平<1mg/L,n=198例),B组(高敏C反应蛋白水平在1~3mg/L,n=102例),C组(高敏C反应蛋白水平>3mg/L,n=100例)。观察测定高敏C反应蛋白水平对于老年患者造影剂肾病的影响及相关性。结果 A、B、C组老年患者在增强CT后造影剂肾病(CIN)的发生率为18.18%,28.43%,51.00%,高敏C反应蛋白(hs-CRP)水平越高患者CIN发病率越高;患者年龄、性别、糖尿病、贫血、hs-CRP水平均为CIN发生的独立相关因素,差异均有统计学意义(P<0.05)。分析所有400例CIN患者的所存在的危险因素,从表中可见,随着危险因素数量的增加,老年患者行增强CT后发生造影剂肾病的比率也随之增加。对于危险因素≥5个的患者而言,其CIN发生率更高达60%。结论在进行增强CT前的老年患者hs-CRP水平与日后CIN发病率有一定关系,患者hs-CRP水平越高,患者越容易患得CIN,hs-CRP水平对CIN的诊断具有一定的价值,可作为其诊断指标。
Objective To determine the level of high-sensitivity C-reactive protein in elderly patients before undergoing enhanced CT and to explore the related research and prognostic value of contrast-induced nephropathy in elderly patients with enhanced CT. Methods From June 2016 to October 2017, 400 elderly patients admitted to the department of cardiology of our hospital who planned to receive coronary enhanced CT were selected as clinical research objects. According to the preoperative examination of high-sensitivity C-reactive protein levels, patients were divided into group A(high-sensitivity C-reactive protein level < 1 mg/L, n=198), group B(high-sensitivity C-reactive protein levels between 1 to 3 mg/L, n= 102) and group C(high-sensitivity C-reactive protein level > 3 mg/L, n=100). The effect and correlation of high-sensitivity C-reactive protein levels on contrast nephropathy in elderly patients were observed. Results The incidences of contrast-induced nephropathy(CIN) in elderly patients of group A, B, and C were respectively 18.18%, 28.43%, and 51.00% after enhanced CT. The higher the level of high-sensitivity C-reactive protein(hs-CRP), the higher the incidence of CIN in patients. Age, gender, diabetes, anemia and hs-CRP levels of patients were all independent factors of CIN, and the differences were statistically significant(P<0.05). The risk factors existing in all 400 cases of CIN were analyzed. As can be seen from the table, with the increase in the number of risk factors, the incidence of contrast-induced nephropathy in elderly patients after enhanced CT was also increased. For patients with more than 5 risk factors, the incidence of CIN was up to 60%. Conclusion The hs-crp level of elderly patients before enhanced CT has a certain relationship with the incidence of CIN in the future. The higher the hs-crp level of patients, the more likely they are to develop CIN. The hs-CRP level has certain values in the diagnosis of CIN and can be used as a diagnostic index.
作者
谢志辉
黄世安
侯冬子
XIE Zhihui;HUANG Shian;HOU Dongzi(Department of Cardiology,the Third Affiliated Hospital of Sun Yat-Sen University,Yuedong Hospital,Guangdong,Meizhou 514000,China)
出处
《中国医药科学》
2019年第21期16-19,共4页
China Medicine And Pharmacy
基金
广东省梅州市科技计划项目（2016B115）
关键词
高敏C反应蛋白
增强CT
造影剂肾病
危险因素
High-sensitivity C-reactive protein
Enhanced CT
Contrast-induced nephropathy
Risk factors
