H型高血压与AMI患者急诊PCI后对比剂肾病的关系研究

Association between H-type hypertension and contrast-induced nephropathy in patients with acute myocardial infarction undergone PCI

目的:探讨H型高血压与ST段抬高型心肌梗死(STEMI)患者接受急诊经皮冠状动脉介入治疗(PCI)术后发生对比剂肾病(CIN)的关系。方法:选取我院2013-01-2015-01收治的117例首次发生STEMI伴有高血压并接受急诊PCI术治疗的患者为研究对象。其中男67例,女50例,平均年龄(59.4±9.3)岁。根据患者是否伴有血同型半胱氨酸(homocysteine,Hcy)水平升高,分为H型高血压组(Hcy≥10μmol/L,77例)和非H型高血压组(Hcy<10μmol/L,40例),并测定两组患者术前及术后第1,2,3天血清肌酐及尿素氮水平,术后第2天的血脂,血Hcy,并用改良的MDRD公式计算估算的术后肾小球滤过率(eGFR),比较H型高血压组与非H型高血压组发生CIN患者比例及肾功能指标;应用Logistic回归分析法筛选CIN发生的危险因素。结果:H型高血压组CIN患者比例显著高于非H型高血压组(P<0.05);Logistic回归分析结果表明,H型高血压是CIN的相关危险因素。结论:H型高血压与STEMI患者行急诊PCI术后CIN的发生可能相关。

Objective：To investigate the relationship between H-type hypertension and contrast-induced nephropathy（CIN）in patients with acute myocardial infarction undergone primary PCI.Method：From January 2013 to January 2015,117 patients with hypertension complicated with acute myocardial infarction treated in The Zheng Zhou University Affiliated Luo Yang Central Hospital were enrolled as study subjects,included 67 male and 50 female patients,and the average age were（59.4±9.3）years.All the patients underwent primary PCI.And according to the Hcy level,all the patients were divided into H-type hypertension group（HCY≥10μmol/L,n=77）and non H-type hypertension group（HCY〈10μmol/L,n=40）.And tested the SCr and BUN in the plasma between the two groups before and after PCI for three consecutive days.The blood lipids and Hcy Level were also indentified the next day of PCI.Estimated glomerular filtration rate（eGFR）was calculated with the simplified Modification of Diet in Renal Disease（MDRD）equation in all these patients.The proportion of patients with CIN,renal function data were compared between H-type hypertension group and non H-type hypertension group.The risk factors of CIN were screened by Logistic regression analysis.Result：In H-type hypertension group,the proportion of patients with CIN were significantly higher than that in non H-type hypertension group（P〈0.05）.Using logistic regression analysis,H-type hypertension was found to be a significant risk factor of CIN.Conclusion：H-type hypertension is closely related to the CIN in patients with acute myocardial infarction undergone primary PCI.