对比剂相关急性肾损伤对缺血性脑卒中患者近期预后的影响

发布时间：2018-11-28 12:44

【摘要】：目的:观察缺血性卒中患者脑血管造影后对比剂相关急性肾损伤(CI-AKI)对住院死亡率及1年死亡率的影响。方法:回顾性纳入2009-01-01~2013-12-31在广东省人民医院接受脑血管造影介入术的缺血性脑卒中患者,收集患者造影前、造影过程中及造影后相关临床资料,通过多因素回归模型分析CI-AKI对住院死亡率及1年死亡率的影响。结果:共有1 820例接受脑血管造影的缺血性脑卒中患者纳入本研究,其中81例(4.5%)患者发生了CI-AKI。多因素Logistic回归模型显示脑血管造影后CI-AKI增加患者住院死亡风险(优势比OR=3.99;95%CI 1.43~11.14;P=0.008),同时多因素COX回归模型显示CI-AKI也是1年死亡的独立危险因素(风险比HR=1.96;95%CI 1.18~3.26;P=0.009)。结论:脑血管造影后CI-AKI是缺血性卒中患者住院死亡及1年死亡的独立危险因素,对接受脑血管造影患者采取有效措施预防CI-AKI十分必要。
[Abstract]:Objective: to observe the effect of contrast agent-associated acute renal injury (CI-AKI) on hospital mortality and 1-year mortality in patients with ischemic stroke. Methods: the clinical data of patients with ischemic stroke undergoing interventional cerebrovascular angiography in Guangdong Provincial people's Hospital were retrospectively collected before, during and after angiography. The effects of CI-AKI on hospital mortality and 1 year mortality were analyzed by multivariate regression model. Results: a total of 1 820 ischemic stroke patients underwent cerebrovascular angiography were included in this study, of which 81 (4.5%) had CI-AKI.. Multivariate Logistic regression model showed that CI-AKI increased the risk of death in hospital after cerebrovascular angiography (OR=3.99;95%CI 1.43 / 11.14). At the same time, the multivariate COX regression model showed that CI-AKI was also an independent risk factor for one year's death (the risk ratio was 1.183.26p 0.009). Conclusion: CI-AKI after cerebral angiography is an independent risk factor of death in hospital and one year in patients with ischemic stroke. It is necessary to take effective measures to prevent CI-AKI in patients undergoing cerebrovascular angiography.
【作者单位】：广东省人民医院肾内科广东省医学科学院;
【基金】：国家临床重点专科建设项目国家自然科学基金面上项目(81170683)
【分类号】：R743.3

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