PCI前后血管生成素-2水平与急性心梗伴CKD患者肾功能指标的相关性

Correlation between angiopoietin-2 levels before and after PCI and renal function indexes in patients with acute myocardial infarction and CKD

目的:探讨急性心肌梗死(AMI)伴慢性肾脏病(CKD)患者行经皮冠状动脉介入(PCI)前后血管生成素-2(Ang-2)水平与肾功能指标的相关性。方法:纳入2018年4月—2020年5月期间我院收治的行PCI治疗的AMI伴CKD患者56例,设为CKD组;另选取同期行PCI治疗的不伴CKD的AMI患者60例设为对照组;收集两组患者临床资料、实验室指标;分别于患者入院时、PCI术后24~48 h内测定血清Ang-2水平,于入院时、PCI术后72 h测定患者肾功能指标[血清肌酐(Scr)、尿素氮(BUN)、估计肾小球滤过率(eGFR)];采用Spearman线性方程分析PCI前后Ang-2水平与肾功能指标的相关性。结果:(1)组内比较,入院时CKD组Scr、BUN水平高于PCI术后72 h,eGFR水平低于PCI术后72 h,差异具有统计学意义(P<0.05);对照组PCI治疗前后Scr、BUN、eGFR水平比较差异无统计学意义(P>0.05);(2)入院时两组患者Ang-2水平比较差异无统计学意义(P<0.05);PCI术后CKD组Ang-水平与入院时差异无统计学意义(P>0.05),对照组Ang-2水平明显降低(P<0.05),PCI术后CKD组Ang-2水平高于对照组(P<0.05);(3)Pearson线性相关性分析显示,CKD组入院时Ang-2水平与Scr、BUN、eGFR无明显相关性(r=0.012、0.000、0.009,P>0.05),PCI术后CKD组Ang-2水平与Scr、BUN水平呈正相关(r=0.588、0.564,P<0.05),与eGFR呈负相关(r=-0.799,P<0.05)。结论:PCI术后血清Ang-2水平与肾功能指标显著相关,有可能成为早期预测造影剂肾病的新生物学标志物。

Objective:To investigate the correlation between angiopoietin-2 levels and renal function indexes in patients with acute myocardial infarction and chronic kidney disease before and after PCI.Methods:Fifty-six patients with acute myocardial infarction and chronic kidney disease who underwent percutaneous coronary intervention in our hospital from April 2018 to May 2020 were enrolled and set as the CKD group;In addition,60 AMI patients without CKD who underwent PCI during the same period were selected as the control group;Collect clinical data and laboratory indicators of two groups of patients;Serum Ang-2 levels were measured on admission and within 24 to 48 hours after PCI,and renal function indicators(serum creatinine,urea nitrogen,and estimated glomerular filtration rate)were determined on admission and 72 hours after PCI;Spearman linear equation was used to analyze the correlation between Ang-2 levels and renal function indexes before and after PCI.Results:(1)Compared within the group,levels of Scr and BUN in the CKD group were higher than 72 hours after PCI,and level of eGFR was lower than 72 hours after PCI,the difference was statistically significant(P<0.05);There was no significant difference in Scr,BUN,eGFR levels before and after PCI treatment in the control group(P>0.05).(2)There was no significant difference in the Ang-2 level between the two groups of patients on admission(P<0.05).There was no significant difference between the Ang-level of the CKD group after PCI and the time of admission(P>0.05).The Ang-2 level of the control group was significantly reduced(P<0.05).The Ang-2 level of the CKD group after PCI was higher than that of the control group(P<0.05).(3)Pearson linear correlation analysis showed that there was no significant correlation between Ang-2 level and Scr,BUN,eGFR at admission in the CKD group(r=0.012,0.000,0.009,P>0.05).Ang-2 level in CKD group after PCI was positively correlated with Scr and BUN levels(r=0.588,0.564,P<0.05),and negatively correlated with eGFR(r=-0.799,P<0.05).Conclusion:The serum Ang-2 level after PCI is significantly correlated with renal function indicators,and may become a new biomarker for early prediction of contrast-induced nephropathy.