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降钙素原对急性冠状动脉综合征患者行冠状动脉介入治疗后发生造影剂肾病的影响
作者:侯建同  鄢高亮  刘波  李瑞峰  罗二飞  汤成春  马根山 
单位:东南大学附属中大医院 心内科, 江苏 南京 210009
关键词:降钙素原 造影剂肾病 经皮冠状动脉介入治疗 急性冠状动脉综合征 
分类号:R541.4;R692
出版年·卷·期(页码):2017·36·第三期(343-347)
摘要:

目的:探讨降钙素原(PCT)对急性冠状动脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)后发生造影剂肾病(CIN)的影响。方法:选取260例在我院心内科行PCI治疗的ACS患者,根据入院时PCT水平分为高水平(PCT>0.5 ng·ml-1)组和低水平(PCT≤0.5 ng·ml-1)组,探讨PCT水平对ACS患者PCI术后CIN发生率的影响及其因素。结果:260例患者共发生CIN 22例,发生率为8.5%。与低水平组(4.6%)相比,高水平组CIN发生率(12.3%)显著增加(P=0.026)。多因素Logistic回归分析显示,校正年龄、糖尿病、高脂血症、超敏C反应蛋白(hs-CRP)、估算肾小球滤过率(eGFR)、左心室射血分数(LVEF)及水化混杂因素后,PCT>0.5 ng·ml-1是发生CIN的独立危险因素(OR=1.6,95%CI为1.2~5.31,P=0.032)。结论:高水平的PCT可能促进ACS患者PCI术后CIN的发生。

Objective:To explore the impact of procalcitonin(PCT)on contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS). Methods:Two hundred and sixty patients undergoing PCI in the cardiology department of our hospital were enrolled in this study. Patients were divided into high-level group(PCT>0.5 ng·ml-1)and low-level group(PCT ≤ 0.5 ng·ml-1)according to PCT tertiles on admission to investigate the influence of PCT level on the incidence of CIN after PCI and its influencing factors. Results:CIN occurred in 22(8.5%)of 260 enrolled patients, and the incidence of CIN in high-level group(12.3%)was significantly increased compared with that in the low-level group(4.6%)(P=0.026). Multivariate Logistic regression analysis found that PCT>0.5 ng·ml-1 was an independent risk factor of CIN after adjustment for age, diabetes, hyperlipidemia, hs-CRP, eGFR, LVEF and hydration confounders(OR=1.6, 95%CI 1.2-5.31, P=0.032). Conclusion:High levels of PCT may increase the occurrence of CIN after PCI in patients with ACS.

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