To Investigate The Relationship Between Body Mass Index And Contrast Induced Nephropathy In Patients Undergoing Percutaneous Coronary Intervention

Background:With the widespread development of PCI technology,increasing contrast agent in clinical use of contrast nephropathy(contrast-induced,nephropathy,CIN)the incidence rate also increased is the third largest cause of the hospital acquired acute kidney injury[1].CIN is a complication of iodine contrast agent after PCI operation,the mortality rate is35%.The current clinical treatment for CIN has no effective,for patients at high risk for preoperative evaluation,proper use and minimize the use of dose contrast agent;preventive interventions such as hydration,early accurate diagnosis and treatment;to reduce the incidence and harm[2].Serum creatinine(Scr)is often used as an early indicator of CIN in clinic.Elderly,heart failure,anemia,diabetes,hypertension and other factors have been identified as CIN risk factors.With the development of social economy,raise the level of human diet,obesity has become an important issue of social health,coronary heart disease,hypertension,obesity is not only an important risk factor for diabetes,obesity can lead to renal injury that obesity related nephropathy [3].Body mass index(BMI)has been used as a diagnostic criteria for obesity,and the "ideal body weight" has been a popular pursuit of protection.Obesity and CIN occurs through a common inflammatory pathways linked to obesity may be independently associated with CIN and [4],have been reported in obesity induced glomerular hyperfiltration can increase the weight of the renal tubular sodium absorption effect on renal protection may reduce the occurrence of CIN[4].Objective:This study disscuss the relationship between body mass index(BMI)and contrast induced nephropathy(48h)was studied by the analysis of body mass index(BMI)and the change of creatinine.Methods:The object of study selected from January 2016 to December2016 in our hospital underwent percutaneous coronary intervention surgery patients,a total of 352 cases,including 262 cases of male,female 90 cases,mean age 57.94 ± 9.45 years old,the average weight of 72.80 ± 10.86 kg.All the selected patients.Clinical data were collected,including the general condition of patients(such as weight,height,age,sex),medical history(hypertension,diabetes,hyperlipidemia,kidney disease),medication history,physical examination,laboratory examination(including the improvement of blood routine,blood routine,liver function,renal function,electrolytes,blood lipids and blood glucose),ECG,chest X-ray and echocardiography and other percutaneous coronary intervention in the routine preoperative examination.The selected patients were divided into two groups according to body mass index in BMI<24 group and BMI ≥ 24.The basic characteristics and routine examination were recorded,and the routine drug treatment such as anticoagulation and anti platelet aggregation was given.Two groups of patients with normal saline for 0.9% to 4 hours before the 1ml/kg/h static point,for water for 24 hours after two NS group was given intravenous injection of 20 mg furosemide and continue to 1ml/kg/h.Scr was measured before and 48 hours after operation.Body mass index(BMI)= body weight(kg)/ height ^2(m).The data were collated by SPSS19.0 statistical software.The normal distribution of the measured data using the mean ± standard deviation;non normal distribution measurement data using the median(four digit spacing);the comparison between the parameters of the two groups using independent sample t test.The classification data were compared by chi square test.Screening risk factors of contrast induced nephropathy by logistic regression analysis.There was statistical difference with P<0.05.Results:The two groups under baseline clinical characteristics such as gender,smoking history,diabetes mellitus,acute myocardial infarction,multivessel disease,oral statins,oral ACEI/ARB,contrast agent type,ejection fraction,serum BNP,C-reactive protein,hemoglobin,cholesterol,bloodglucose,24 hour access amount.No statistically significant difference(P>0.05).There were significant differences in age,left ventricular size,E/e ’,hypertension(P<0.05).The incidence of contrast induced nephropathy in two groups was 1.16% and 9.02%,respectively(P<0.05).Logistic regression analysis showed that BNP,body mass index and the incidence of contrast induced nephropathy are CIN risk factors.Conclusions: Give a low dose of furosemide in hydration,body mass index,serum BNP and contrast nephropathy,elevated BNP and BMI≥24 are risk factors for CIN.