血浆同型半胱氨酸水平对老年急性冠状动脉综合征患者经皮冠状动脉介入术后对比剂肾病发生的影响研究  

Study on Plasma Hcy levels in elderly patients with acute coronary syndromes PCI postoperative contrast medium nephropathy impact

作　　者：王群立[1] 白江涛[1] 崔展[1] 张胜[1] 

机构地区：[1]江苏省常州市第一人民医院心内科,江苏常州213000

出　　处：《中国临床医生杂志》2017年第4期22-26,共5页Chinese Journal For Clinicians

摘　　要：目的探讨血浆中同型半胱氨酸(Hcy)水平对老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后对比剂肾病(CIN)发生的影响。方法收集首次采取PCI治疗的144例老年ACS患者为研究对象,依照患者术前血浆中Hcy水平分成高水平Hcy组(血浆Hcy≥10μmoL/L)84例、低水平Hcy组(血浆Hcy<10μmol/L)60例。对比两组患者的临床资料以及PCI术后CIN的发生率,且应用Logistic多因素回归分析老年ACS患者在PCI治疗后CIN发生的风险因子。结果老年ACS患者在PCI治疗后CIN的发生率为19.4%;高水平Hcy组患者术后CIN发生率为22.6%,明显高于低水平Hcy组的15.0%(P<0.05):通过Logistic多因素回归分析,在校正相关因子后,高水平1Hcy组患者PCI术后CIN发生风险明显高于低水平Hcy组(OR=1.69,95%CI1.59~2.65,P=0.020)。结论老年ACS患者在PCI治疗前血浆中Hcy高表达可能会增加术后CIN的发生风险。Objective To investigate the correlation between the plasma homocysteine（Hcy） levels in elderly patients with acute coronary syndrome（ACS）after percutaneous coronary intervention（PCI） postoperative contrast agent the effects of Contrast-induced nephropathy（CIN）.Method A total of 144 cases of elderly patients with ACS as the research object from January 2012 to December 2012 in cardiology Dept.of changzhou 1 st people＇s Hospital,who could be cured for the first time to take PCI treatment,according to the patients in the high level of Hcy preoperative plasma Hcy levels in groups（Hcy≥10 μmol/L）,84 cases of plasma Hcy,low levels of Hcy group（10 μmol/L）60 cases.Compared the clinical data of two groups of patients and the incidence of CIN after PCI,Logistic multi-factor regression analysis and application in elderly patients with ACS risk factors in treatment of CIN after PCI.Result In elderly patients with ACS in the incidence of CIN after PCI therapy was 19.4%;The incidence of CIN postoperatively in patients with high levels of Hcy group was 22.6%.significantly higher than the 15.0%of the low levels of Hcy group（P〈0.05）;By Logistic regression analysis,multiple factors after correction of the relevant factors,the high level of Hcy group of CIN after PCI in patients with significantly higher risk of deeloping lower than the level of Hcy group（OR=1.69,95%CI 1.59 to 2.65,P=0.020）.Conclusion In elderly patients with ACS in before PCI treatment plasma Hcy high expression may increase the risk of CIN after cardiac surgery.

关 键 词：老年急性冠状动脉综合征 经皮冠状动脉介入 对比剂肾病 同型半胱氨酸 

分 类 号：R541.6[医药卫生—心血管疾病]