PCI术与CKD患者CRS发病率的相关研究

目的 探讨经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)对慢性肾脏疾病(chronic kidney disease, CKD)患者1型心肾综合征(cardiorenal syndrome, CRS)发病率的影响。方法发生急性心肌梗死(acute myocardial infarction, AMI)的84例CKD患者,根据住院期间是否发生急性肾损伤(acute kidney injury, AKI)分为1型CRS组和无CRS组,对两组患者PCI治疗情况、造影剂用量、血清尿素氮、血清肌酐和死亡率进行统计学分析。结果 84名CKD合并AMI患者有37例发生1型CRS(44%),1型CRS组患者与无CRS组患者PCI治疗比例(48.6% vs 53.2%, P＞0.05),造影剂用量(130±48ml vs 148±55ml, P＞0.05)均无统计学差异,43例行PCI治疗的患者手术前后血清肌酐值变化无显著差异(140.8±40.4 vs 141.2±63.7umol/l, P＞0.05),其中22名患者PCI术后血肌酐显著下降(153.9±39.7 vs 105.9±22.9umol/l, P＜0.01)。结论本组资料提示PCI术未增加CKD患者1型CRS发病率。
Objective To investigate whether percutaneous coronary intervention (PCI) increases the incidence of cardiorenal syndrome (CRS) type 1 in patients with chronic kidney disease (CKD). Methods Eighty four CKD patients complicated with acute myocardial infarction (AMI) underwent PCI in our hospital. The clinical data of patients were retrospectively reviewed and the relationship of PCI with the incidence and mortality of type 1 CRS was analyzed. Results of 84 patients, 37 (44％) developed acute kidney injury (AKI).There was no significant in the incidence of PCI and dose of contrast agent between CRS and non-CRS groups (48.6% vs 53.2%, and (130±48)ml vs (148±55)ml,respectively, both P＞0.05). The average serum creatinine of 43 patients has no significant difference before and after PCI [(140.8±40.4)μmol/L vs (141.2±63.7)μmol/L, P＞0.05], however, in 22 patients the serum creatinine levels were decreased from (153.9±39.7) μmol/L before PCI to (105.9±22.9)μmol/L after PCI (P＜ 0.01). Conclusion The results indicate that PCI may not increase the incidence of type 1 CRS in patients with chronic kidney disease