尿微量白蛋白和胱抑素C与对比剂肾病的相关性

目的：探索尿微量白蛋白（MAU）和胱抑素C（CysC）与对比剂肾病（CIN）的相关性。方法：选取2011年1月-2013年6月在本院心血管2科住院接受经皮冠状动脉介入（PCI）治疗的205例心绞痛患者，按照是否发生CIN分为CIN组和非CIN组，所有患者PCI术前和术后3 d监测MAU、CysC和肌酐（Scr）。比较两组PCI前后上述指标的变化，采用logistic回归分析评估MAU、CysC与CIN的相关性。结果：205例患者中共有17例住院期间发生CIN（8.29%）。CIN组的MAU及CysC在24 h内出现变化，48 h开始下降，术后各时间段水平均明显高于术前及非CIN组相应时间的水平（P〈0.05）；CIN组Scr水平的变化出现在48 h，48 h和72 h的Scr水平均明显高于术前和非CIN组同一时间的水平（P〉0.05）；非CIN组的PCI术前/后MAU、CysC和Scr数值无明显变化（P＆gt;0.05）。多因素logistic回归分析校正年龄、性别、贫血、对比剂用量与糖尿病病史，可知PCI术前MAU、CysC水平是CIN的独立预测因子（P〈0.05）；对比剂使用量与CIN发生率显著相关（P〈0.05）。结论：MAU、CysC的变化能够早期预测CIN发生，MAU、CysC可能是CIN的独立危险因素。

Correlation between Microalbuminuria and CystatinC with Contrast-induced Nephropathy

Objective：To explore the correlation between microalbuminuria（MAU）,cystatinC（CysC）with contrast-induced nephropathy（CIN）.Method：205 angina patients underwent percutaneous coronary intervention（PCI） from January 2011 to June 2013 in our hospital were selected,they were randomly divided into CIN group and non CIN group according to the occurrence of CIN.MAU,CysC and Scr of all patients were continuous detected before PCI and within 72 hours after PCI.The changes of above index among two groups were compared.Using logistic regression analysis, the association between MAU,CysC and CIN were assessed.Result：A total of 17 cases occurred CIN（8.29%）during in hospital.In CIN group,MAU and CysC levels changed in 24 hours and reached the peak in 48 h after PCI,it was significantly higher than those before contrast injection in CIN group and those after contrast injection of non-CIN group, respectively（P〈0.05）.The serum creatinine levels were similar to those before PCI in 24 h and it began to rise in 48 h in CIN group.It had significantly statistics differences in 48 h to 72 h compared with before contrast injection and non-CIN group （P〈0.05）.There was no significant difference between CysC,MAU and Scr levels before and after PCI at 24,48,72 h in non-CIN group（P〉0.05）.Multivariate logistic regression analysis,adjusted for age,sex,anemia,the amount of contrast medium and diabetes,display MAU,CysC were independent predictors of CIN（P〈0.05）.The amount of contrast agent samely associated with incidence of CIN（P〈0.05）.Conclusion：Changes of MAU,CysC can predict the occurrence of CIN in early stage,MAU,CysC may be the independent risk factors for CIN.