高尿酸血症对合并系统性炎症反应综合征ACS 患者PCI术后造影剂肾病的影响∗

摘要

Objective:To observe the influence of serum uric acid (UA)on contrast-induced nephropathy (CIN)in patients with acute coronary syndrome (ACS)and systemic inflammatory response syndrome (SIRS)un-dergoing percutaneous coronary intervention (PCI).Method:A total of 276 patients with ACS undergoing coronary angiography and PCI were assigned to SIRS group (group A,n=77)and no-SIRS group (group B,n=199). Then,according to the level of serum uric acid,group A was assigned into hyperuricemia group (group A1,n=30) and normal serum uric acid group (group A2,n=47),group B also was assigned into hyperuricemia group (group B1,n=42)and normal serum uric acid group (group B2,n=157).The serum levels of hs-CRP,IL-6 and uric acid at pre-stenting and after PCI were detected.The incidence rate of contrast-induced nephropathy was monitored after PCI.Results:At pre-stenting,the serum levels of UA,hs-CRP and IL-6 in group A,A1 and B1 were significantly higher than group B,A2 and B2,respectively (P<0.05).The serum levels of UA,hs-CRP and IL-6 in group A was the highest.The 3rd day after PCI,the accidence rate of contrast-induced nephropathy in group A,A1 and B1 were higher than group B,A2 and B2,respectively (P<0.05).The incidence rate of CIN in group A1 was the highest.Conclusion:The hyperuricemia is a influential factor of CIN in patients with ACS and SIRS after PCI.%目的：观察血尿酸(UA)水平对合并系统性炎症反应综合征(SIRS)的急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后造影剂肾病(CIN)的影响。方法：276例接受冠状动脉造影+PCI 的 ACS患者,根据是否并发 SIRS分为 SIRS组(A组,n=77)和非 SIRS 组(B 组,n=199)；再根据血 UA 水平分别将 A 组分为高UA组(A1组,n=30)和正常 UA组(A2组,n=47),将B组也分为高 UA组(B1组,n=42)和正常 UA组(B2组,n=157)。观察各组PCI术前血 UA、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平及术后 CIN 发生率。结果：术前,A组、A1组、B1组 UA、hs-CRP 及 IL-6水平分别高于 B组、A2组和 B2组(P<0.05),其中 A1组最高。术后3天,A组、A1组、B1组CIN发生率分别高于B组、A2组及 B2组(P<0.05),其中 A1组最高。结论：高 UA合并 SIRS的 ACS患者PCI术后易发CIN。