脂蛋白(a)与冠心病患者介入诊疗后造影剂肾病发生的相关性  

Correlation between lipoprotein(a) and contrast-induced nephropathy after percutaneous coronary intervention in patients with coronary heart disease

作　　者：郑坚奕[1] 朱桂平[1] 曾智桓[1] 王宗涛[1] 余星 冉鹏[2] 林展翼[2] ZHENG Jian-yi;ZHU Gui-ping;ZENG Zhi-huan;WANG Zong-tao;YU Xing;RAN Peng;LIN Zhan-yi(Department of Cardiology,The First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510086,China;Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510010,China)

机构地区：[1]广东药科大学附属第一医院心内科,广州510086 [2]广东省心血管病研究所广东省人民医院(广东省医学科学院),广州510010

出　　处：《岭南心血管病杂志》2019年第2期142-145,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨脂蛋白(a)[lipoprotein(a),Lp(a)]与冠状动脉粥样硬化性心脏病(冠心病)患者行经皮冠状动脉介入诊疗后发生造影剂肾病(contrast-induced nephropathy,CIN)之间的相关性。方法选取2011年1月至2013年12月于广东省人民医院行冠心病介入诊疗的患者共1 737例作为研究对象。根据基础Lp(a)浓度,将患者分为高Lp(a)组及Lp(a)组正常组,收集两组患者的临床资料,对比两组间基线资料及CIN的发生率,分析患者发生CIN的相关因素。结果高Lp(a)组与Lp(a)组正常组相比,两组间患者性别、年龄、吸烟,原发性高血压(高血压)、糖尿病、阿司匹林、他汀类药物、术中造影剂用量及术前水化治疗剂量等基线资料比较,差异无统计学意义(P>0.05);两组间血红蛋白、白蛋白、糖化血红蛋白(HbA1c)、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、尿酸浓度比较,差异无统计学意义(P>0.05)。尽管高Lp(a)组基础肌酐浓度升高[(86.81±26.04)μmol/L vs.(84.54±22.69)μmol/L,P<0.05],但两组间CIN的发生率相近,差异无统计学意义(8.62%vs. 8.55%,P>0.05)。相关性分析结果显示,年龄、急性肾功能、糖尿病、高血压、低蛋白血症、贫血与CIN发生存在相关性(P<0.05),但患者的血脂浓度、Lp(a)、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇等均未发现与CIN的发生存在相关(P>0.05)。结论 Lp(a)较高的冠心病患者肌酐浓度较高,LP(a)与CIN的发生暂未发现存在明确相关性。Objectives To investigate the relationship between lipoprotein (a)[Lp(a)] and contrast-induced nephropathy(CIN)after percutaneous coronary intervention in patients with coronary heart disease.Methods A total of 1 737 patients who underwent coronary intervention in Guangdong Provincial People′s Hospital between January 2011 and December 2013 were included in this study.The patients were divided into high Lp(a)group and control group according to the baseline concentration of Lp(a).We retrospectively analyzed the clinical information and compared incidence of CIN between the two groups.Spearman correlation test was tested to analyze the risk factors of CIN.Results There was no significant difference in baseline data between the two groups in terms of gender,age,smoking,hypertension,diabetes,aspirin and statin used,dosage of contrast agent and hydration dose.There were no significant differences in concentrations of hemoglobin,albumin,glycosylated hemoglobin(HbA1c),total cholesterol,low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and uric acid between the two groups(P>0.05).Although concentration of basic creatinine was higher in high Lp(a)group[(86.81±26.04)μmol/L vs.(84.54±22.69)μmol/L,P<0.05],incidence of CIN in the two groups was similar(8.62% vs.8.55%,P > 0.05).Correlation analysis showed that age,acute renal function,diabetes,hypertension,hypoalbuminemia and anemia related to the occurrence of CIN(P < 0.05),but LP(a),LDL-C and HDL-C did not correlate with the occurrence of CIN(P > 0.05).Conclusions Concentration of LP(a)correlate with concentration of creatinine in patients with coronary heart disease,but dose not associate with the incidence of CIN.

关 键 词：冠状动脉疾病 脂蛋白(a) 造影剂肾病 

分 类 号：R541.4[医药卫生—心血管疾病]