【摘要】：目的:探索行急診經(jīng)皮冠狀動脈介入治療(PCI)的患者血漿大內(nèi)皮素水平與術(shù)后出現(xiàn)對比劑誘導(dǎo)的急性腎損傷(CI-AKI)的相關(guān)性。方法:選取2013-01-01到2015-06-30于阜外醫(yī)院行急診PCI的患者共1 061例納入研究。根據(jù)大內(nèi)皮素水平將患者分為大內(nèi)皮素正常組(n=236)和大內(nèi)皮素升高組(n=825),分析兩組患者基線資料和介入操作特征,以及CI-AKI發(fā)生率和術(shù)后6個月、12個月復(fù)合終點事件(包括非致死性心肌梗死、再次血運重建、腦卒中和全因死亡)發(fā)生率,并進行Logistic分析明確CI-AKI的危險因素。結(jié)果:行急診PCI的患者術(shù)后CI-AKI發(fā)生率為22.7%(241/1 061)。大內(nèi)皮素升高組患者CI-AKI發(fā)生率和術(shù)后6個月、12個月復(fù)合終點發(fā)生率均顯著高于大內(nèi)皮素正常組(P值分別為0.041、0.040和0.021)。校正其他變量后,大內(nèi)皮素不論作為連續(xù)性變量還是分類變量均顯著增加急診PCI患者術(shù)后CI-AKI的風(fēng)險。結(jié)論:在行急診PCI的患者中,血漿大內(nèi)皮素水平升高會顯著增加患者術(shù)后CI-AKI的風(fēng)險。
[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.
【作者單位】： 北京協(xié)和醫(yī)學(xué)院中國醫(yī)學(xué)科學(xué)院國家心血管病中心阜外醫(yī)院冠心病中心;新疆維吾爾自治區(qū)烏魯木齊市友誼醫(yī)院;
【基金】：國家衛(wèi)生和計劃生育委員會公益性行業(yè)科研專項(201402001)
【分類號】：R541.4

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