冠心病合并高同型半胱氨酸血症与造影剂肾病的相关性研究

The correlation of hyperhomocystinemia and contrast-induced nephropathy in patients with coronary heart disease

目的探讨冠心病合并高同型半胱氨酸血症(HHcy)对造影剂肾病(CIN)发生率的影响。方法选取郑州大学第一附属医院心内科2014年1月至2014年8月就诊并行冠脉造影术(CAG)的136例患者,记录一般资料,根据冠脉造影术前48 h内测得的血清同型半胱氨酸(Hcy)水平,将患者分为两组:CHD无HHcy组(58例)和CHD合并HHcy组(78例),于造影前48 h内及术后第1、2、3天分别检测血肌酐(Scr)水平,比较造影术后造影剂肾病的发病情况。结果 CHD合并HHcy组总胆固醇、低密度脂蛋白、NT-pro BNP水平高于CHD无HHcy组,差异有统计学意义(P<0.05)。Logistic回归分析显示,总胆固醇、低密度脂蛋白是Hcy升高的独立危险因素(P<0.05)。造影后第3天CHD合并HHcy组Scr明显高于CHD无HHcy组,e GFR低于CHD无HHcy组,差异均有统计学意义(P<0.05)。CHD合并HHcy组CIN发病率高于CHD无HHcy组(P<0.05)。结论冠心病合并高同型半胱氨酸血症与造影剂肾病存在一定相关性。

Objective To investigate the effect of hyperhomocystinemia （HHcy）on the morbidity of contrast-induced ne-phropathy （CIN）in patients with coronary heart disease （CHD）.Methods Data of 136 patients underwent CAG and admitted to the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from August of 2014 to January of 2014 were recorded.All the patients were divided into CHD without HHcy group （58 cases）and CHD with HHcy group （78 cases） 48 h according to the levels of Hcy.The levels of serum creatinine （Scr）,glomerular filtration rate （eGFR）were detected 48 hours before CAG and one,two,three days after CAG respectively.The morbidities of CIN were compared between the two groups.Results The levels of total cholesterol,low density lipoprotein,NT-proBNP in CHD with HHcy group were higher than CHD without HHcy group,and the differences were statistically significant （P〈0.05 ）.Logistic regression analysis showed that total cholesterol,low density lipoprotein were the independent risk factors of HHcy.The level of Scr in CHD with HHcy group was higher and the level of eGFR was lower than CHD without HHcy group,and the differences were statistically significant （P〈0.05 ）.The morbidity of CIN in CHD with HHcy group was higher than CHD without HHcy group （P 〈0.05 ）. Conclusion HHcy ia related to CIN in patients with CHD.