甘肃地区伴NT-pro BNP升高冠心病患者PCI术后造影剂肾病的影响因素分析

Analysis of influencing factors of contrast-enhanced nephropathy after PCI in patients with coronary heart disease in Gansu with NT-pro BNP

目的分析甘肃地区伴NT-proBNP升高冠心病患者对PCI术后造影剂肾病的影响作用。方法将本院自2015年1月至2019年1月间收治的冠心病行PCI手术治疗的患者486例作为研究对象,分为NT-proBNP升高组(A组)251例,NT-proBNP未升高组(B组)235例,分析NT-proBNP升高对术后患者发生造影剂肾病的影响作用。结果PCI术后A组患者NT-proBNP水平明显升高,B组明显降低,A组患者合并心血管不良事件(心源性死亡、急性心力衰竭、心肌梗死、心绞痛、恶性心律失常等)发生率为53.39%,明显高于B组15.74%(P<0.05);PCI术后两组患者血肌酐、尿β2球蛋白、抑胱素、肌酸激酶等指标比较差异具有统计学意义(P<0.05);将患者是否发生CIN作为因变量(0=无,1=有),将单因素分析中有统计学意义的变量纳入到二分类,结果显示,患者年龄、高血压、心功能衰竭为PCI治疗合并NT-proBNP升高冠心病患者术后发生CIN的独立危险因素。结论伴NT-proBNT升高的冠心病患者行PCI治疗后会增减心血管不良事件的发生率,患者年龄、NT-proBNP升高、心功能衰竭为冠心病患者PCI术后发生CIN的独立危险因素。

Objective To analyze the effect of NT-pro BNP-induced coronary heart disease patients on contrast-enhanced renal disease after PCI in Gansu.Methods A total of 486 patients with PCI who underwent PCI in our hospital from January 2015 to January 2019 were enrolled.The patients were divided into NT-pro BNP group(group A) with 251 cases,NT-pro.In the BNP non-elevated group(group B),235 cases were analyzed for the effect of elevated NT-pro BNP on postoperative contrast nephropathy.Results The level of NT-pro BNP was significantly increased in group A after PCI,and significantly decreased in group B.Group A patients with cardiovascular adverse events(cardiac death,acute heart failure,myocardial infarction,angina pectoris,malignant arrhythmia,etc.) occurred.The rate was 53.39%,which was significantly higher than 15.74% in group B.The difference between the two groups was statistically significant(P<0.05).The indexes of serum creatinine,urinary β2 globulin,cystatin and creatine kinase were compared between the two groups after PCI.The difference was statistically significant(P<0.05);whether the patient had CIN as a dependent variable(0=none,1=yes),the statistically significant variables in the univariate analysis were included in the second classification,and the results showed that the patient’s age Hypertension and heart failure were independent risk factors for postoperative CIN in patients with coronary heart disease who underwent PCI with NT-pro BNP.Conclusions Patients with coronary heart disease with elevated NT-pro BNT may have an increased incidence of cardiovascular adverse events after PCI.Patients with age,elevated NT-pro BNP,and heart failure are CIN in patients with coronary heart disease after PCI.Independent risk factors.