急性冠脉综合征合并H型高血压经皮冠状动脉造影术后对比剂肾病的研究

Clinical study for contrast-induced nephropathy after coronary angiography in patients with acute coronary syndrome and H hypertension

目的探讨接受经皮冠状动脉造影(CAG)检查的急性冠脉综合征(ACS)患者,H型高血压与对比剂肾病(CIN)是否具有某种联系。方法选取接受CAG检查的ACS患者275例,其中H型高血压189例,非H型高血压86例,分析患者临床基线资料、血肌酐(Cr)、估算肾小球滤过率(eGFR)和CIN危险因素。结果 CIN发病率H型高血压(n=31,16.4%)高于非H型高血压(n=7,8.1%),差异有统计学意义(P <0.05);术后72 h内H型高血压血Cr水平[(83.79±29.62)vs.(66.82±26.31)μmol/L]高于非H型高血压,H型高血压eGFR水平[(66.81±20.92)vs.(75.29±18.28) mL/min]低于非H型高血压,差异均有统计学意义(P <0.05);Logistic回归分析显示,高龄、贫血、糖尿病、慢性肾病、H型高血压、对比剂用量和左心室射血分数降低是CIN的主要危险因素(P <0.05)。结论 H型高血压可能是CIN的危险因素之一。

Objective To explore the relationship between H-type hypertension and contrast induced nephropathy(CIN) after percutaneous coronary angiography(CAG) in patients with acute coronary syndrome (A CS). Methods 275 ACS patients who underwent CAG examination were selected,including 189 patients with H-type hypertension and 86 patients with non-H-typy hypertension. The baseline clinical data,serum creatinine, glomerular filtration rate and CIN risk factors were analyzed. Results The incidence of CIN in H-type hypertension group(31 cases,16.4%) was higher than that in non-H-type hypertension group(7 cases,8.1%)(P < 0.05). The Cr in H-type hypertension group was higher than that of non-H-type hypertension group within 72 hours after operation[( 83.79 ± 29.62)vs.( 66.82 ± 26.31)μmol/L], and the eGFR in H-type hypertension group was lower than that of non-H-type hypertension group[( 66.81 ± 20.92)vs.( 75.29 ± 18.28) mL/min], the difference was statistically significant(P < 0.05). Logistic regression analysis showed that age,anemia,diabetes,chronic kidney disease,H-type hypertension,dosage of contrast agent,and left ventricular ejection fraction were the main risk factors for CIN after CAG(P < 0.05). Conclusion The H-type hypertension maybe one of the risk factors for CIN after CAG.