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血管内主动脉修复术后造影剂肾病的预测指标——造影剂体积与估计肾小球滤过率的比值

The ratio of contrast medium volume to estimated glomerular filtration rate as a predictor of contrast-induced nephropathy after endovascular aortic repair.

作者信息

Kawatani Yohei, Kurobe Hirotsugu, Nakamura Yoshitsugu, Hori Takaki, Kitagawa Tetsuya

机构信息

Department of Cardiovascular Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School.

Department of Cardiovascular Surgery, Chiba-Nishi General Hospital.

出版信息

J Med Invest. 2018;65(1.2):116-121. doi: 10.2152/jmi.65.116.

Abstract

OBJECTIVE

This study aimed to determine the perioperative predictors of contrast medium-induced nephropathy (CIN) after endovascular aortic repair (EVAR).

MATERIALS AND METHODS

The data of 203 consecutive patients who underwent elective EVAR for thoracic and abdominal aortic aneurysm between January 2014 and September 2014 were retrospectively analyzed. CIN was defined according to the diagnostic criteria of the European Society of Urogenital Radiology.

RESULTS

Fourteen patients (6.9%) developed CIN after EVAR. Contrast medium volume (CV), preoperative serum creatinine, estimated glomerular filtration rate (eGFR), and the CV/eGFR ratio were significantly related with CIN development after EVAR. The CV/eGFR ratio was significantly higher in patients with CIN than those without CIN. Receiver operator characteristic curve analysis showed that the area under the curve of the CV/eGFR ratio was 0.782, indicating that it was the most important predictor. The appropriate CV/eGFR ratio cutoff was 1.62. Sensitivity and specificity were 85.7% and 65.6%, respectively.

CONCLUSIONS

The CV/eGFR ratio was a useful predictor of contrast medium-induced nephropathy after EVAR. It is possible that the score can be used in patients when managing the EVAR techniques and contrast medium volume. J. Med. Invest. 65:116-121, February, 2018.

摘要

目的

本研究旨在确定血管腔内主动脉修复术(EVAR)后造影剂诱导的肾病(CIN)的围手术期预测因素。

材料与方法

回顾性分析2014年1月至2014年9月期间连续203例行胸主动脉和腹主动脉瘤择期EVAR患者的数据。CIN根据欧洲泌尿生殖放射学会的诊断标准定义。

结果

14例患者(6.9%)在EVAR后发生CIN。造影剂用量(CV)、术前血清肌酐、估计肾小球滤过率(eGFR)以及CV/eGFR比值与EVAR后CIN的发生显著相关。发生CIN的患者的CV/eGFR比值显著高于未发生CIN的患者。受试者工作特征曲线分析显示,CV/eGFR比值的曲线下面积为0.782,表明它是最重要的预测因素。合适的CV/eGFR比值临界值为1.62。敏感性和特异性分别为85.7%和65.6%。

结论

CV/eGFR比值是EVAR后造影剂诱导的肾病的有用预测因素。在管理EVAR技术和造影剂用量时,该评分可能适用于患者。《医学调查杂志》65:116 - 121,2018年2月。

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