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目的:探讨H型高血压与ST段抬高型心肌梗死(STEMI)患者接受急诊经皮冠状动脉介入治疗(PCI)术后发生对比剂肾病(CIN)的关系。方法:选取我院2013-01-2015-01收治的117例首次发生STEMI伴有高血压并接受急诊PCI术治疗的患者为研究对象。其中男67例,女50例,平均年龄(59.4±9.3)岁。根据患者是否伴有血同型半胱氨酸(homocysteine,Hcy)水平升高,分为H型高血压组(Hcy≥10μmol/L,77例)和非H型高血压组(Hcy<10μmol/L,40例),并测定两组患者术前及术后第1,2,3天血清肌酐及尿素氮水平,术后第2天的血脂,血Hcy,并用改良的MDRD公式计算估算的术后肾小球滤过率(eGFR),比较H型高血压组与非H型高血压组发生CIN患者比例及肾功能指标;应用Logistic回归分析法筛选CIN发生的危险因素。结果:H型高血压组CIN患者比例显著高于非H型高血压组(P<0.05);Logistic回归分析结果表明,H型高血压是CIN的相关危险因素。结论:H型高血压与STEMI患者行急诊PCI术后CIN的发生可能相关。
Objective: To investigate the relationship between Hypertension and contrast-induced nephropathy (CIN) after emergency percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 117 patients with STEMI complicated with hypertension undergoing emergency PCI during our hospital from January 2013 to January 2015 were enrolled in this study. There were 67 males and 50 females with an average age of 59.4 ± 9.3 years. Patients were divided into H type hypertension group (Hcy≥10μmol / L, 77 cases) and non-H type hypertension group (Hcy <10μmol / L) according to whether the patients had homocysteine (Hcy) , 40 cases). The levels of serum creatinine and blood urea nitrogen, blood lipid and blood Hcy on the second day after operation were measured before operation and on the 1st, 2nd and 3rd postoperative days. The postoperative patients were evaluated with modified MDRD formula Glomerular filtration rate (eGFR) were calculated. The proportion of CIN patients and the renal function indexes of Hypertension group and non-Hypertension group were compared. Logistic regression analysis was used to screen the risk factors of CIN. Results: The proportion of CIN in Hypertension group was significantly higher than that in non Hypertension group (P <0.05). Logistic regression analysis showed that Hypertension was the related risk factor of CIN. Conclusion: Hypertension may be associated with the occurrence of CIN after emergency PCI in patients with STEMI.