中文摘要：

目的分析腔内治疗周围动脉疾病术后造影剂肾病（CIN）发生的危险因素，以及血清胱蛋白酶抑制剂C（CysC）与血清肌酐（Scr）在诊断肾损伤时的符合情况。方法本研究为前瞻性、单中心研究，2010年7月至2011年4月在本院血管外科接受非急诊周围动脉疾病腔内治疗术的住院患者入选。根据造影后Scr升高≥25％标准判断是否发生CIN，分为非CIN组和CIN组，比较两组患者的一般临床资料和血液生化指标；行相关危险因素的Logistic回归分析；分析造影前后Scr和血清CysC变化分布以及两者诊断CIN的符合情况。结果367例患者入选。CIN组并发糖尿病比例、造影剂用量、术前利尿剂合并用药比例均显著高于非CIN组，差异有统计学意义（P分别〈0．05、〈0．01、〈0．01）。Logistic回归分析结果显示，并发糖尿病、造影剂用量为CIN的危险因素。采用术后24h血清CysC任何程度的升高、升高≥5％、≥8％、≥10％、≥15％、≥25％及绝对值升高≥0．2mg／L标准预测Scr诊断标准诊断的CIN的灵敏度均较低。维恩图显示两指标诊断肾损伤患者的集合重叠区域均较小。结论造影剂用量、糖尿病为CIN发生的独立危险因素。造影后血清CysC升高标准与Scr标准在诊断肾损伤上符合情况较差。

英文摘要：

Objective To investigate the risk factors for contrast-induced nephropathy （CIN） after endovascular therapy in patients with peripheral arterial diseases and to evaluate the conformance of serum cystatin C （Cys C） and serum creatinine in diagnosis of CIN. Methods In this prospective, single center study, in-hospital patients with peripheral arterial diseases undergoing non-emergency endovascular therapy from July 2010 to April 2011 in our hospital were enrolled. CIN was defined as Scr increase I〉25% after angiography. General clinical characteristics and blood biochemical parameters were compared between the non-CIN and CIN groups. Logistic regression analysis was performed to determine risk factors. Changes compared to baseline level in serum creatinine and Cys C at predefined time-points were evaluated. Results A total of 367 patients were enrolled in the study. The proportions of patients with diabetes mellitus and treatment with diuretics before angiography, contrast-media dosage were significantly higher in the CIN groupthan those in non-CIN group （P〈O.05, 〈0.01, 〈0.01）. Logistic regression analysis indicated that diabetes mellitus, contrast-media dosage were risk factors for CIN. Several serum Cys C increase criteria at 24 hours after contrast media exposure all had low sensitivity for predicting a Scr increase≥25%. Only small overlapped regions were found in Venn diagram between several increasing criteria according to serum Cys C and serum creatinine criterion. Conclusions Diabetes mellitus, contrast-media dosage are independent risk factors for CIN. The results of several increasing criteria according to serum Cys C in evaluating contrast-induced AKI are not coincident well with that of serum creatinine criterion.