【摘要】 目的:探究血清半乳糖凝集素-3(Galectin-3)与冠心病患者造影剂肾病(CIN)间的关系。方法:选取2018年4-12月于本院行冠状动脉造影术(CAG)的冠心病患者[包括行经皮冠状动脉介入术(PCI术)者]80例,根据造影后患者是否发生CIN,将其分为CIN组和无CIN组。比较两组年龄、高血压发生情况、胆固醇、低密度脂蛋白、N末端B型脑钠肽前体(NT-proBNP)、造影剂用量、左心室射血分数、血清Galectin-3水平;比较两组造影前后血肌酐(Scr)和肾小球滤过率(eGFR)变化情况;对CIN患者进行多因素Logistic回归分析,筛选其危险因素;分析患者Galectin-3水平与上述各参数间的相关性。结果:CIN组7例(8.75%),无CIN组73例(91.25%);两组年龄和高血压发生率比较,差异均无统计学意义(P>0.05);两组胆固醇、低密度脂蛋白、NT-proBNP、造影剂用量、左心室射血分数、Galectin-3水平比较,差异均有统计学意义(P<0.05);造影后第3天,两组Scr水平均高于造影前,且CIN组Scr水平高于无CIN组,差异均有统计学意义(P<0.05),CIN组eGFR水平均低于造影前及无CIN组(P<0.05),无CIN组造影前后eGFR水平比较,差异无统计学意义(P>0.05);Logistic回归分析显示,左心室射血分数和eGFR是CIN的保护因素(OR<1,P<0.05),而胆固醇、低密度脂蛋白、NT-proBNP、造影剂用量、Scr以及Galectin-3水平均是CIN发生的危险因素(OR>1,P<0.05);Pearson相关性分析结果显示,患者Galectin-3水平与高血压发生情况、左心室射血分数、eGFR均呈负相关(P<0.05),与年龄、胆固醇、低密度脂蛋白、NT-proBNP、造影剂用量、Scr均呈正相关(P<0.05)。结论:Galectin-3水平升高与冠心病患者CIN发生存在着密切关联,可用于CIN的预测和诊断。更多还原

【Abstract】 Objective: To explore the relationship between serum Galectin-3 and contrast-induced nephropathy(CIN) in patients with coronary heart disease. Method: From April to December 2018, 80 patients with coronary heart disease [included those undergoing percutaneous coronary intervention(PCI)] underwent coronary angiography(CAG) in our hospital were selected. The patients were divided into CIN group and non CIN group according to whether CIN occurred after angiography. The age, the incidence of hypertension, cholesterol, low density lipoprotein, N-terminal B-type brain natriuretic peptide precursor(NT-proBNP), the dosage of contrast medium, left ventricular ejection fraction and serum Galectin-3 were compared between the two groups, the changes of serum creatinine(Scr) and glomerular filtration rate(eGFR) before and after contrast were compared between the two groups, the risk factors of CIN patients were screened by multivariate logistic regression analysis, and the correlation between Galectin-3 level and the above parameters was analyzed. Result: There were 7 cases(8.75%) in CIN group and 73 cases(91.25%) in non CIN group. There were no significant differences in age and hypertension between the two groups(P>0.05), there were significant differences in the levels of cholesterol, low density lipoprotein, NT-pro BNP, contrast agent dosage, left ventricular ejection fraction and Galectin-3 between the two groups(P<0.05). On the third day after contrast, the Scr levels of the two groups were higher than those of before contrast, and the Scr level of the CIN group was higher than that of the non CIN group, the differences were statistically significant(P<0.05), the eGFR levels of the CIN group were lower than those of before contrast and non CIN group(P<0.05), but there was no significant difference in eGFR between the two groups before and after contrast(P>0.05). Logistic regression analysis showed that left ventricular ejection fraction and eGFR were protective factors of CIN(OR<1, P<0.05), while cholesterol, low density lipoprotein, NT-proBNP, contrast agent dosage, Scr and Galectin-3 were all risk factors of CIN(OR>1, P<0.05). Pearson correlation analysis showed that Galectin-3 level were negatively correlated with hypertension, left ventricular ejection fraction and eGFR(P<0.05), and positively correlated with age, cholesterol, low density lipoprotein, NT-proBNP, contrast agent dosage and Scr(P<0.05). Conclusion: The increase of Galectin-3 level is closely related to the occurrence of CIN in patients with coronary heart disease, which can be used for the prediction and diagnosis of CIN.更多还原