行急诊经皮冠状动脉介入治疗患者血浆大内皮素水平与术后对比剂诱导急性肾损伤的相关性分析

发布时间：2018-08-26 18:24

【摘要】：目的:探索行急诊经皮冠状动脉介入治疗(PCI)的患者血浆大内皮素水平与术后出现对比剂诱导的急性肾损伤(CI-AKI)的相关性。方法:选取2013-01-01到2015-06-30于阜外医院行急诊PCI的患者共1 061例纳入研究。根据大内皮素水平将患者分为大内皮素正常组(n=236)和大内皮素升高组(n=825),分析两组患者基线资料和介入操作特征,以及CI-AKI发生率和术后6个月、12个月复合终点事件(包括非致死性心肌梗死、再次血运重建、脑卒中和全因死亡)发生率,并进行Logistic分析明确CI-AKI的危险因素。结果:行急诊PCI的患者术后CI-AKI发生率为22.7%(241/1 061)。大内皮素升高组患者CI-AKI发生率和术后6个月、12个月复合终点发生率均显著高于大内皮素正常组(P值分别为0.041、0.040和0.021)。校正其他变量后,大内皮素不论作为连续性变量还是分类变量均显著增加急诊PCI患者术后CI-AKI的风险。结论:在行急诊PCI的患者中,血浆大内皮素水平升高会显著增加患者术后CI-AKI的风险。
[Abstract]:Aim: to explore the correlation between plasma endothelin level and contrast media-induced acute renal injury (CI-AKI) in patients with (PCI) undergoing emergency percutaneous coronary intervention. Methods: a total of 1,061 patients with emergency PCI from January 2013 to June 30, 2015-06-30 in Fuwei Hospital were included in the study. According to the level of large endothelin, the patients were divided into two groups: normal large endothelin group (nang236) and large endothelin elevation group (nang825). The baseline data and interventional characteristics of the two groups were analyzed. The incidence of CI-AKI and the incidence of complex end point events (including non-fatal myocardial infarction, re-revascularization, stroke and all-cause death) at 6 months and 12 months after operation were analyzed by Logistic to determine the risk factors of CI-AKI. Results: the incidence of postoperative CI-AKI in emergency patients with PCI was 22.7% (241 / 1061). The incidence of CI-AKI and the incidence of complex endpoints at 6 months and 12 months after operation were significantly higher in the patients with greater endothelin elevation than in the normal large endothelin group (P = 0.041, 0.040 and 0.021, respectively). After adjusting for other variables, large endothelin significantly increased the risk of CI-AKI in emergency PCI patients both as a continuous variable and a classification variable. Conclusion: elevated plasma endothelin levels significantly increased the risk of postoperative CI-AKI in patients with emergent PCI.
【作者单位】：北京协和医学院中国医学科学院国家心血管病中心阜外医院冠心病中心;新疆维吾尔自治区乌鲁木齐市友谊医院;
【基金】：国家卫生和计划生育委员会公益性行业科研专项(201402001)
【分类号】：R541.4

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