摘要
目的分析老年缺血性脑卒中(CIS)患者CT血管造影术(CTA)后碘对比剂相关性急性肾损伤(PC-AKI)的影响因素及患者预后。方法回顾性分析2023年1月至2024年12月广西医科大学第七附属医院/梧州市工人医院收治的150例接受CTA检查的老年缺血性脑卒中(CIS)患者的临床资料,根据患者CTA后48 h内是否发生PC-AKI,分为发生组(n=38)和未发生组(n=112),采用单因素分析及多因素Logistic回归分析老年CIS患者CTA后发生PC-AKI的影响因素,并分析两组预后。结果单因素分析结果显示,发生组术前应用血管紧张素转化酶抑制剂(ACEI)比例、合并糖尿病比例、血肌酐(Scr)基线值及超敏C反应蛋白(hs-CRP)水平均高于未发生组(P<0.05);多因素Logistic回归分析结果显示,术前应用ACEI、合并糖尿病、Scr基线值升高及hs-CRP水平升高是老年CIS患者CTA后发生PC-AKI的独立影响因素(OR>1,P<0.05);CTA后6个月内,发生组死亡率为15.79%(6/38),高于未发生组的1.79%(2/112)(P<0.05)。结论老年CIS患者CTA后PC-AKI的发生率较高,术前应用ACEI、合并糖尿病、Scr基线值及hs-CRP水平升高是其主要危险因素,临床应重点识别,以预防PC-AKI发生,改善患者预后。
Objective To analyze the influencing factors and prognosis of postcontrast acute kidney injury(PC-AKI)in elderly patients with cerebral ischemic stroke(CIS)undergoing CT angiography(CTA).Methods A retrospective analysis was conducted on the clinical data of 150 elderly patients with ischemic stroke(CIS)who underwent CTA at the Seventh Affiliated Hospital of Guangxi Medical University/Wuzhou GongRen Hospital from January 2023 to December 2024.The occurrence of PC-AKI after CTA was recorded for all patients,who were then divided into two groups:the occurrence group(n=38)and the non-occurrence group(n=112).Univariate analysis and multivariate Logistic regression analysis were used to identify the influencing factors of PCAKI after CTA in elderly CIS patients.Additionally,the prognosis of the two groups was compared.Results Univariate analysis showed that the occurrence group had a higher proportion of preoperative ACEI use and diabetes comorbidity,as well as higher baseline serum creatinine(Scr)and high-sensitivity C-reactive protein(hs-CRP)levels compared to the non-occurrence group(P<0.05).Multivariate logistic regression analysis revealed that preoperative use of ACEIs,comorbid diabetes,elevated baseline Scr levels,and elevated hs‑CRP levels were independent influencing factors for PC-AKI after CTA in elderly patients(OR>1,P<0.05).Within 6 months after CTA,the mortality rate in the occurrence group was 15.79%(6/38),which was significantly higher than that in the non-occurrence group(1.79%,2/112)(P<0.05).Conclusion The incidence of PC-AKI after CTA is relatively high in elderly CIS patients.Clinical attention should be focused on high-risk patients with preoperative ACEI use,diabetes comorbidity,and elevated baseline Scr and hs-CRP levels to prevent PC-AKI and improve patient prognosis.
作者
黎琳
吴光铭
叶宁
LI Lin;WU Guangming;YE Ning(Department of Pharmacy,The Seventh Affiliated Hospital of Guangxi Medical University/Wuzhou GongRen Hospital,Wu Zhou,Guangxi 543000,China)
出处
《医师在线》
2026年第1期71-74,共4页
Journal of Doctors Online
基金
梧州市科技计划项目(202202150)。
