术前超敏C反应蛋白水平对急诊冠脉介入治疗后造影剂肾病发生率的影响  

Influence of preoperative Hs-CRP Levels on incidence of contrast-induced nephropathy in urgent coronary interventions

作　　者：王立中[1] 曹树军[1] 张银[1] 张建维[1] 胡硕强[1] 王文斌[1] 

机构地区：[1]首都医科大学大兴医院,北京102600

出　　处：《现代中西医结合杂志》2013年第27期2971-2973,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的了解术前超敏C反应蛋白(hs-CRP)水平对行急诊冠脉介入治疗术的急性ST段抬高型心肌梗死患者造影剂肾病(CIN)发生率的影响。方法选取接受急诊冠脉介入治疗术的急性ST段抬高型心肌梗死患者545例,均应用低渗非离子造影剂,测定介入治疗前和术后第1—3天肾功能,了解CIN发生的独立危险因素,分析hs-CRP水平对CIN发生率的影响。结果 545例患者中,男391例,女154例;发生CIN 108例,发病率为19.8%。CIN患者年龄、糖尿病、hs-CRP、血糖及再灌注时间与非CIN患者比较有显著性差异(P均<0.05);CIN患者全因死亡率、心源性死亡率、恶性心律失常发生率增加(P均<0.05);多因素Logistic回归分析显示,血糖水平、hs-CRP水平是CIN发生的独立的危险因素。hs-CRP水平采取四分法,显示和CIN的发生率密切相关。结论术前的hs-CRP水平和急诊冠脉介入治疗的急性心肌梗死患者CIN的发生密切相关,是CIN独立的危险因素,增加急性心肌梗死患者住院期间病死率。Objective It is to observe the influence of preoperative high-sensitivity C -reactive protein （Hs -CRP） levels on incidence of contrast-induced nephropathy （CIN） in patients with ST - segment elevation myocardial infarction undergoing urgent pereutaneous coronary interventions. Methods 545 patients with ST - segment elevation myocardial infarction undergo- ing urgent coronary interventions were enrolled and all patients were received low-osmolality nonionic contrast agent. The renal function was detected at baseline and each day for following three days. The independent risk factors of CIN was observed, and the influence of preoperative Hs - CRP levels on incidence of CIN was analyzed. Results Among 545 patients, there were 391 males and 154 females. CIN were occurred in 108 patients, the incidence was 19.8 %. There were significant differences in age, DM, Hs- CRP, blood glucose, LVEF and reperfusion time between CIN and non CIN group （P 〈 0.05）. Patients with CIN had higher risk of in-hospital all-cause mortality, cardiac death, aiThythmias （P 〈 0.05）. Multivariate analysis showed blood glucose, Hs - CRP were independent risk factors of CIN. Elevated Hs - CRP levels as variables categorized into quar- tiles were independently associated with CIN （ P 〈 0.05 ）. Conclusion The preoperative Hs - CRP level may be a powerful and independent risk factor for CIN in patients with ST - segment elevation myocardial infarction undergoing urgent percutane- ous coronary interventions, it is associated with in-hospital mortality.

关 键 词：超敏C反应蛋白 造影剂肾病 急诊冠脉介入治疗 

分 类 号：R692[医药卫生—泌尿科学]