目的探讨CT增强扫描造影剂肾 病的危险因素及水化干预效果观察。方 法 选取2015年1月-2018年1月来院行介入 冠状动脉造影的240例患者临床资料，随 机分成A、B两组，其中A组120例患者接受 水化干预，B组120例患者不接受水化干 预。将A组未发生CIN的110例患者纳入对 照组，B组30例发生CIN的患者纳入观察 组。统计所有患者基本信息，分析观察组 及对照组CIN发生情况。结果 240例患者 中有50例患者发生CIN，发生率16.67%。 两组患者造影剂剂量、血肌酐水平比较无 差异(P>0.05)，观察组cystatinC低于对 照组(P<0.05)。观察组患者冠心病、糖尿 病、高血压、充血性心力衰竭并存率显著 高于对照组(P<0.05)。充血性心力衰竭、 糖尿病、基线cystatinC、基线血肌酐是 CIN发生独立危因素(P<0.05)。对照组患 者中有110例未发生CIN，比例为91.67%。 观察组患者中有90例未发生CIN，比例为 75.00%。结论 患者在充分水化后使用 造影剂可有效预防CIN；发生CIN的危险 因素为充血性心力衰竭、糖尿病、基线 cystatin C、基线血肌酐；血清cystatin C与血肌酐比较，预测CIN强度更高。

Objective To investigate the risk factors of CT enhanced scan contrast agent nephropathy and the effect of hydration intervention. Methods The clinical data of 240 case of patients who underwent coronary angiography in our hospital from January 2015 to January 2018 were randomly divided into two groups, A group and B group. Among them, group A(120 cases) was given hydration intervention, B group(120 cases) was not given hydration intervention. 110 patients with no CIN in A group were into the control group, and 30 cases of CIN in group B were into the observation group. The basic information of all patients was analyzed, and the occurrence of CIN in the observation group and the control group was analyzed. Results 50 of the 240 patients had CIN, and the incidence was 20.83%. There was no difference between the two groups in the dose of contrast medium and the level of serum creatinine(P>0.05), and the cystatinC of the observation group was lower than that of the control group (P<0.05). The rate of coexistence of coronary heart disease, diabetes, hypertension and congestive heart failure of the observation group was significantly higher than that of the control group (P<0.05). Congestive heart failure, diabetes, baseline cystatinC, and baseline serum creatinine were independent risk factors for CIN (P<0.05).110 of the patients in the control group had no CIN, and the proportion was 91.67%. 90 of the patients in the observation group had no CIN, and the proportion was 75%. Conclusion The use of contrast agents can effectively prevent CIN after full hydration, and congestive heart failure, diabetes, baseline cystatin C and baseline serum creatinine are the the risk factors for CIN. The serum cystatin C can predict the intensity of CIN higher than the serum creatinine.