Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI). Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min•1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients. Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence. Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.%目的：研究肾功能正常或轻度损害[估算肾小球滤过率（eGFR）≥60 ml/（min·1.73 m2）]的急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后对比剂肾病的发生率，分析对比剂肾病发病的危险因素及主要不良心血管事件。 方法：回顾2013-06至2015-06在第二炮兵总医院心血管内科行PCI的eGFR≥60 ml/（min·1.73 m2）的ACS患者254例。依据对比剂肾病定义[血清肌酐水平升高0.5 mg/dl（44.2μmol/L）或比基础值升高25%]分为对比剂肾病组（n=23）和非对比剂肾病组（n=231），记录所有患者的基线资料、实验室指标和手术指标，计算eGFR值。 结果：254例eGFR≥60 ml/（min·1.73 m2）的ACS患者PCI术后23例发生对比剂肾病，发生率为9%。多元Logistic回归分析显示：急诊PCI（OR=0.370，95%CI：0.060~2.297）、N末端B型利钠肽原（NT-proBNP）水平（OR=4.209，95%CI：1.202~14.742）和既往未规律服用阿司匹林（OR=7.950，95%CI：1.108~57.034）是对比剂肾病发生的危险因素。 结论：肾功能正常或轻度损害的ACS患者PCI术后对比剂肾病发生的危险因素是急诊PCI、NT-proBNP升高和既往未规律服用阿司匹林。
展开▼
