中山大学学报（医学科学版）Issue(5)：659-663,5.
糖尿病下肢血管成形术后患者对比剂肾病的危险性
Risk of Contrast Induced Nephropathy in Diabetic Patients with Lower Extremity Arterial Disease Undergoing Percutaneous Transluminal Angioplasty
摘要
Abstract
[Objective] To investigate the incidence of and risk predictive factors for contrast induced nephropathy (CIN) following lower extremity percutaneous transluminal angioplasty (PTA), and to evaluate the renal safety of this examination or treatment in diabetic patients with lower extremity arterial disease. [Methods] From February to July in 2010,141 consecutive patients who underwent lower extremity PTA were analyzed retrospectively. All patients were divided into diabetic group (n = 91 ) or non-diabetic group (n=S0). Demographic characteristics and the total volume of injected contrast medium were recorded. Baseline characteristics including the levels of hemoglobin, fasting plasma glucose, lipid profile, serum creatinine, as well as the serum creatinine level at 48 h after angioplastic procedure were measured. Independent t-test, chi-squre test and logistic regression model were applied. [Results] The age was higher in diabetic group than that in non-diabetic group [ (71 ± 9) vs (63 ±17) years, P = 0.003], while the hemoglobin level was lower in diabetic group than that in non-diabetic group [ (124 ± 20) vs (134 ± 25) g/L, P = 0.016]. In diabetic patients, the volume of contrast medium was lower in the subgroup of impaired renal function than that in the normal renal function group [ (48 ± 15) vs (57 ±18) mL,P = 0.039]. The incidence of CIN was no significant difference between diabetic and non-diabetic groups(7.7% vs 2.0%,P = 0.260). Logistic regression demonstrated that hemoglobin level was an independent predictor of CIN (B = -0.075, OR = 0.928, 95%CI: 0.868 ~ 0.991, P = 0.026). [Conclusions] Taking effective prophylaxis and restricting contrast medium volume, may reduce the risk of CIN in diabetic patients after angioplastic procedure. Decreased hemoglobin level, an independent predictor of CIN, has been shown in diabetic patients, and should be corrected.关键词
对比剂肾病/糖尿病/下肢动脉造影/经皮腔内血管成形术Key words
contrast induced nephropathy/ diabetes/ percutaneous transluminal angioplaty分类
医药卫生引用本文复制引用
刘丹,杨淼,张童,石波,马鲁波,于春利,严励..糖尿病下肢血管成形术后患者对比剂肾病的危险性[J].中山大学学报（医学科学版）,2011,(5):659-663,5.基金项目
广东省自然科学基金重点资助项目(10251008901000010) （10251008901000010）
