首页|Mehran评分用于老年人群造影剂肾病风险评估效果分析

Mehran评分用于老年人群造影剂肾病风险评估效果分析

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目的 验证Mehran评分用于老年冠状动脉粥样硬化性心脏病(简称冠心病)人群造影剂肾病(CIN)风险评估的效果。方法 收集上海某院心血管内科 2015 年 1 月至 2017 年 12 月行经皮冠状动脉介入(PCI)术老年(>65 岁)患者的临床资料(包括基本信息、合并症、实验室指标及合并用药情况),采用单因素和二元Logistic回归分析评估发生CIN的危险因素及与Mehran评分的相关性。结果 共纳入 378 例患者,其中 45 例(11。90%)围术期发生CIN,Mehran分级为低危(≤5分)、中危(6~10分)、高危(11~15分)、极高危(≥16分)的患者分别有 182 例、147 例、41 例、8 例,且各组患者CIN发生率差异有统计学意义(P<0。05)。二元Logistic回归分析结果表明,术前预估肾小球滤过率(eGFR)[OR = 0。939,95%CI(0。883,0。998),P = 0。044]及Mehran危险分级为高危[OR = 3。414,95%CI(1。116,10。441),P = 0。031]和极高危[OR = 9。604,95%CI(1。311,70。355),P = 0。026],是预测老年冠心病患者PCI术后发生CIN的重要因素。结论 术前eGFR及Mehran危险分级为高危、极高危,为预测老年冠心病患者PCI术后CIN发生风险的影响因素。
Effect Analysis of Mehran Score on the Risk Assessment of Contrast-Induced Nephrology in the Elderly
Objective To verify the effect of Mehran score applied in the risk assessment of contrast-induced nephropathy(CIN)in elderly patients with coronary heart disease(CHD).Methods The clinical data(including basic information,complications,laboratory indicators,combined medication)of elderly patients(>65 years)underwent percutaneous coronary intervention(PCI)in the Department of Cardiovascular Medicine of a hospital in Shanghai from January 2015 to December 2017 were collected.The univariate analysis and binary Logistic regression analysis were used to evaluate the risk factors for CIN and its correlation with Mehran score.Results A total of 378 patients were included,of which 45(11.90%)had CIN during the perioperative period;182,147,41,eight patients had low risk(≤five points),medium risk(six to ten points),high risk(11 to 15 points),extremely high risk(≥16 points)respectively based on the Mehran grading,and the incidence of CIN in each group was significantly different(P<0.05).The binary Logistic regression analysis showed that the preoperative estimated glomerular filtration rate(eGFR)[OR = 0.939,95%CI(0.883,0.998),P = 0.044],high risk of Mehran grading[OR = 3.414,95%CI(1.116,10.441),P = 0.031]and extremely high risk of Mehran grading[OR = 9.604,95%CI(1.311,70.355),P = 0.026]were important factors in predicting the occurrence of CIN in elderly patients with CHD after PCI.Conclusion Preoperative eGFR,high risk,extremely high risk of Mehran grading are the influencing factors in predicting the occurrence of CIN in elderly patients with CHD after PCI.

elderlycoronary heart diseasepercutaneous coronary interventioncontrast-induced nephropathyMehran scorerisk prediction

裘齐宁、陆浩、殷嘉晟、徐烨、叶岩荣、章雯珺

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复旦大学附属中山医院厦门医院,福建 厦门 361015

复旦大学附属中山医院,上海 200032

老年 冠状动脉粥样硬化性心脏病 经皮冠状动脉介入术 造影剂肾病 Mehran评分 风险预测

上海市临床重点专科项目

shslczdzk06504

2024

中国药业
重庆市食品药品监督管理局

中国药业

CSTPCD
影响因子:1.369
ISSN:1006-4931
年,卷(期):2024.33(6)
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