急性ST段上升型心肌梗塞病患在經皮冠脈介入治療之顯影劑導致急性腎損傷

本研究係針對因急性ST段上升型心肌梗塞（ST-segment elevation myocardial infarction, STEMI），需緊急施行冠狀動脈攝影及介入性治療後，研討臨床上顯影劑導致急性腎損傷的發生率，及其相關的危險因子分析。此為單一院所回溯性分析，由2010年1月1日始至2016年12月31日止，共收錄331名急性ST段上升型心肌梗塞病患，施作緊急心導管檢查及介入手術後，發生顯影劑導致急性腎損傷的比率。本研究發現，顯影劑導致急性腎損傷的比率為7.6%，與國內外相關文獻比較，本研究之發生率略低。原有慢性腎功能缺損患者發生顯影劑腎損傷之比率，遠高於腎功能正常患者。經多變項分析，急性心肌梗塞階段，顯影劑導致急性腎功能損傷主要的危險因素為年老及糖尿病。

關鍵字

顯影劑導致急性腎損傷；慢性腎臟病；冠脈介入治療

並列摘要

This study investigated the occurrence of contrast-induced nephropathy (CIN) in patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention and evaluated the risk factors for CIN. This single-center retrospective study included 331 patients with STEMI from January 1, 2010, to December 31, 2016. The rate of CIN in these patients after emergency cardiac catheterization and interventional surgery was 7.6%, which was slightly lower than that reported in other foreign and domestic studies. The rate of CIN occurrence in patients with chronic renal failure was significantly higher than that in patients with healthy kidneys. Multivariate analysis revealed that age and diabetes were the major risk factors for CIN in patients with STEMI.

並列關鍵字

contrast-induced acute kidney injury ； chronic kidney disease ； percutaneous coronary intervention

參考文獻

Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl 2006;100:S11-5. doi: 10.1038/sj.ki.5000368

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Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004;44:1393-9. doi: 10.1016/S0735-1097(04)01445-7

Baydar O, Kilic A. Acute hyperglycemia and contrast-induced nephropathy in patients with non-ST elevation myocardial infarction. Cardiovasc Endocrinol Metab 2020;9:24-9. doi: 10.1097/XCE.0000000000000187

延伸閱讀

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國際替代計量

急性ST段上升型心肌梗塞病患在經皮冠脈介入治療之顯影劑導致急性腎損傷

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