炎症反应对接受PCI治疗的非ST段抬高ACS患者造影剂肾病的影响

Influence of Inflammatory Response to Contrast-induced Nephropathy in Patients with NST-ACS Undergoing Percutaneous Coronary Intervention

目的:观察接受经皮冠状动脉介入治疗(PCI)的非ST段抬高急性冠脉综合征(NST-ACS)患者炎症反应与造影剂肾病(CIN)的关系。方法:239例NST-ACS患者根据是否并发全身炎症反应综合征(SIRS)分为SIRS组(n=68)及非SIRS对照组(n=171)。两组患者均行PCI,观察PCI术前及术后3天两组患者超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、中性粒细胞明胶酶脂质运载蛋白(NGAL)水平和CIN发生率。结果:术前,SIRS组hs-CRP和IL-6高于对照组(P<0.01),两组患者NGAL无明显差异(P>0.05)。术后3天,两组患者hs-CRP及IL-6均较术前降低,NGAL较术前升高,差异均有统计学意义(P<0.01)。SIRS组hs-CRP、IL-6及NGAL均高于对照组(P均<0.01)。SIRS组CIN发生率高于对照组(P<0.05)。结论:接受PCI治疗NST-ACS患者体内炎症反应可能是导致CIN发生的因素之一。NGAL可能不是CIN发生的影响因素。

Objective: To observe the association between inflammatory response and contrast-induced nephropathy in patients with NST-ACS undergoing percutaneous coronary intervention. Method: A total of 239 patients with NST-ACS were assigned to two groups according to systemic inflammatory response syndrome(SIRS): SIRS group(n=68) and control group(n=171).hs-CRP, IL-6, NGAL at pre-stenting and 3 days post-stenting were detected. Moreover, the incidence rate of contrast-induced nephropathy was monitored. Results: At pre-stenting, the hs-CRP and IL-6 in SIRS group were significantly higher than control group(P<0.01). The NGAL was no significant different in two groups(P>0.05). At 3 days post-stenting, the hs-CRP and IL-6 in two groups were lower than pre-stenting(P<0.01). The NGAL in two groups were higher than pre-stenting(P<0.01). At 3 days post-stenting, the hs-CRP,IL-6 and NGAL in SIRS group were significantly higher than control group(P<0.01).The accidence rate of contrast-induced nephropathy in SIRS group was significantly higher than control group. Conclusion: The inflammatory response may be a factor of contrast-induced nephropathy in patients with NST-ACS undergoing percutaneous coronary intervention. The NGAL may be not an influential factor of contrast-induced nephropathy.