【摘要】 目的 探讨不同糖代谢及相关因素对造影剂肾病(CIN)的影响，明确CIN危险因素。方法 对195例冠脉介入患者完成介入前后相关观察指标的测定收集，比较各组CIN发病率;采用多因素Logistic回归分析CIN发病的危险因素。 结果 1. 糖代谢正常(NGT)、糖耐量受损(IGT)、糖尿病(DM)各组CIN发病率分别为9.5%、22.0%，34.0%(P<0.05)。2. DM并肾功能不全、心功能不全及两者同时合并时CIN发病率分别为60.0%、57.0%、73.3%;不同DM病程(<8年，<16年，≥16年)CIN发生率分别为16.7%、30.8%、58.8%(P<0.05)。3. 多因素分析显示肾功能不全、DM、心功能不全、造影剂高剂量、重复暴露为冠脉介入患者CIN危险因素。结论 糖代谢异常冠脉介入患者CIN发病率高， 且随着DM病程的延长而升高;DM、心、肾功能不全、造影剂高剂量、重复暴露为CIN危险因素。

　　【关键词】造影剂肾病 糖耐量受损 糖尿病 危险因素

　　The effect of different glucose metabolism and related factors on the contrast-induced nephropathy . CHEN Wen-ping，FENG Lie. Department of Endocrinology, The first Affiliated Hospital of Jinan University, Guangzhou 510632, China

　　Corresponding author: FENG Lie, Email: Dr.Fengl@yahoo.com.cn

　　【Abstract】 Objective To compare the characteristics of different glucose metabolism and related factors on the contrast-induced nephropathy(CIN) following coronary intervention and determine the risk factors. Methods 195 Patients who were planned to perform coronary intervention were selected. Observeted data was collected before and after coronary intervention and incidence of CIN was compared. Related risk factors were analyzed with logistic regression analysis Results 1 The CIN incidence of NGT, IGT and DM is 9.5%, 22.0%, 34.0% separately(P<0.05). 2 The CIN incidences in patients with renal, cardiac insufficiency and their concomitant before coronary intervention are 60.0%, 57.0% ,73.3% separately. The CIN incidences in patients with different DM duration (<8ys,<16ys,≥16ys) are 16.7%,30.8%,58.8% separately (P<0.05). 3 Logistic regression analysis shows renal insufficiency, DM, cardiac insufficiency, high volume of contrast medium and repeated expose of contrast medium are risk factors of CIN in patients performed coronary intervention. Conclusions The CIN incidence is higher in abnormal glucose metabolism group. The CIN incidence increased with the DM duration. The CIN incidence in patients with renal or cardiac insufficiency before coronary intervention is higher. Renal insufficiency, DM, cardiac insufficiency, high volume of contrast medium and repeated expose of contrast medium are independent risk factors of CIN in patients performed coronary intervention.

　　【Key words】Contrast-induced nephropathy, Impaired glucose tolerance, Diabetes mellitus, Risk factor