高尿酸血症对合并系统性炎症反应综合征ACS患者PCI术后造影剂肾病的影响

Influence of Hyperuricemia on Contrast-induced Nephropathy in Patients with ACS and SIRS Undergoing Percutaneous Coronary Intervention

目的:观察血尿酸(UA)水平对合并系统性炎症反应综合征(SIRS)的急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后造影剂肾病(CIN)的影响。方法:276例接受冠状动脉造影+PCI的ACS患者,根据是否并发SIRS分为SIRS组(A组,n=77)和非SIRS组(B组,n=199);再根据血UA水平分别将A组分为高UA组(A1组,n=30)和正常UA组(A2组,n=47),将B组也分为高UA组(B1组,n=42)和正常UA组(B2组,n=157)。观察各组PCI术前血UA、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平及术后CIN发生率。结果:术前,A组、A1组、B1组UA、hs-CRP及IL-6水平分别高于B组、A2组和B2组(P<0.05),其中A1组最高。术后3天,A组、A1组、B1组CIN发生率分别高于B组、A2组及B2组(P<0.05),其中A1组最高。结论:高UA合并SIRS的ACS患者PCI术后易发CIN。

Objective：To observe the influence of serum uric acid（UA）on contrast-induced nephropathy（CIN）in patients with acute coronary syndrome（ACS）and systemic inflammatory response syndrome（SIRS）undergoing percutaneous coronary intervention（PCI）.Method：A total of 276 patients with ACS undergoing coronary angiography and PCI were assigned to SIRS group（group A,n=77）and no-SIRS group（group B,n=199）.Then,according to the level of serum uric acid,group A was assigned into hyperuricemia group（group A1,n=30）and normal serum uric acid group（group A2,n=47）,group B also was assigned into hyperuricemia group（group B1,n=42）and normal serum uric acid group（group B2,n=157）.The serum levels of hs-CRP,IL-6and uric acid at pre-stenting and after PCI were detected.The incidence rate of contrast-induced nephropathy was monitored after PCI.Results：At pre-stenting,the serum levels of UA,hs-CRP and IL-6in group A,A1 and B1were significantly higher than group B,A2 and B2,respectively（P〈0.05）.The serum levels of UA,hs-CRP and IL-6in group A was the highest.The 3rd day after PCI,the accidence rate of contrast-induced nephropathy in group A,A1 and B1were higher than group B,A2 and B2,respectively（P〈0.05）.The incidence rate of CIN in group A1 was the highest.Conclusion：The hyperuricemia is a influential factor of CIN in patients with ACS and SIRS after PCI.