高敏C反应蛋白与经皮冠状动脉介入术后对比剂肾病的相关性研究

目的分析经皮冠状动脉介入（PCI）治疗术前高敏C反应蛋白（hs-CRP）水平与患者术后发生对比剂肾病（CIN）的关系。方法选取126例行PCI治疗的患者作为研究对象，根据其术前hs-CRP水平分为A、B、C3组，A组（hs-CRP水平〈lmg／L）纳入患者45例，B组（hs-CRP水平为1～3mg／L）纳入患者41例，C组（hs-CRP水平〉3mg／L）纳入患者40例。对3组患者的临床资料进行整理分析，并观察患者术后CIN的发病情况。结果3组患者术后CIN的发生率分别为11．1％、17．1％和30％，且血清hs-CRP水平较高的患者CIN发生率也较高，3组总体差异和A组与C组的差异均有显著性（均P〈0．05），而A组与B组、B组与C组之间的差异无显著性（P〉0．05）；多因素Logistic回归分析显示，不论是将术前hs-CRP水平作为连续变量还是作为分类变量纳入回归模型，患者术前hs-CRP水平的显著升高都是CIN发病的危险因素（P〈0．05）；患者发生糖尿病也是CIN发病的危险因素（P〈0．05）。在围手术期应用水化治疗和性别为男性是CIN发病的保护因素（P〈0．05）。结论行PCI手术治疗患者的术前hs-CRP水平与其术后CIN的发生具有密切相关关系，是CIN发病的独立危险因素。同时糖尿病也是CIN发病的危险因素，而围手术期应用水化治疗和性别为男性是CIN发病的保护因素。临床医生应密切关注危险因素，及时采取相关处理措施。

Study on the relationship between high sensitivity C-reactive protein and contrast induced nephropathy of the patients after percutaneous coronary intervention treatment

Objectives To observe and analyze the relationship between high sensitivity C reactive protein （hs- CRP） and contrast induced nephropathy （CIN） of the patients after percutaneous coronary intervention （PCI） treatment. Methods 126 cases of patients treated with PCI were selected as the research objects. The patients were divided into A, B, and C group according to the preoperative hs-CRP levels. 45 patients were included in the A group （hs-CRP 〈1 mg/ L）, 41 patients were included in the B group （hs-CRP level of 1 to 3 mg/L） and 40 patients in the C group （hs-CRP level 〉3 mg/L）. The clinical data and the incidence of CIN of the patient were observed and analyzed. Results The inci- dences of CIN of the patients in the three groups after the PCI treatment were 11.1 %, 17.1% and 30% respectively and CIN incidence of the patients with higher level of serum hs-CRP was higher. There was significant difference among the three group and between the A group and C group （P〈0.05）, while the difference between A group and B group, B group and C group was not significant （P〉0. 05） ; multi-factor Logistic regression showed that the preoperative signifi- cantly elevated level of hs-CRP was the risk factor of CIN （P〈0.05） no matter the preoperative hs-CRP level were in- cluded as a continuous variable or as a categorical variable into the regression model. Diabetes of the patients was also a risk factor for the onset of CIN（P〈0.05）, while water treatment application during the peri-operation period and male sex were the protective factors for the onset of CIN（P〈0. 05）. Conclusion There is a close relationship between the preoperative hs-CRP level and the postoperative CIN incidence of the patients underwent PCI operation treatment. The hwCRP level is an independent risk factor for the onset of CIN. At the same time, diabetes is a risk factor in the pathogenesis of CIN, and water treatment application during the peri-operation period and male sex are the protective factors in the pathogenesis of CIN. Clinicians should pay close attention to the risk factors and take timely relevant treatment measures.