血清肌酐、胱抑素C及肾小球滤过率与支架内再狭窄的相关性
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(中国医科大学附属盛京医院心内科,辽宁省沈阳市 110000)

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杨天贵,硕士,主治医师,主要研究方向为冠状动脉介入治疗、电生理、心脏起搏器等,E-mail为yangtg1986@163.com。

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Correlation between serum creatinine, serum cystatin C, glomerular filtration rate and in-stent restenosis
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Department of Cardiology, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110000, China)

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    摘要:

    目的 探讨血清肌酐、血清胱抑素C(CysC)及肾小球滤过率(GFR)与冠状动脉内置入药物洗脱支架后发生支架内再狭窄的相关性。 方法 回顾性分析624例患者,均于冠状动脉内植入药物洗脱支架且于中国医科大学附属盛京医院复查冠状动脉造影,按复查造影结果分为再狭窄组(147例)及非再狭窄组(477例),统计并分析所有患者的临床资料、生化指标、介入靶血管、再狭窄等数据。 结果 无论是PCI术前、术后以及复查造影时,再狭窄组患者的血清肌酐、血清CysC水平均高于非再狭窄组(P<0.05);GFR均低于非再狭窄组(P<0.05);通过多因素Cox回归分析示,血清肌酐及血清CysC水平升高、GFR下降是预测药物洗脱支架内再狭窄的独立危险因子。 结论肾功能水平与支架内再狭窄的发生密切相关,血清肌酐及CysC升高、GFR下降是冠状动脉内药物洗脱支架术后发生再狭窄的独立危险因素。

    Abstract:

    Aim To investigate the correlation between the level of serum creatinine (Cr), serum cystatin C(CysC), glomerular filtration rate (GFR) and in-stent restenosis after coronary artery drug eluting stent implantation. Methods A retrospective analysis of 624 cases of patients were performed coronary drug eluting stents and coronary angiography in Shengjing Hospital of China Medical University, according to the review of coronary angiography results, patients were divided into in-stent restenosis group (147 cases) and non in-stent restenosis group (477 cases), which clinical data, biochemical indicators, interventional target vessels and restenosis data were analysed. Results Both before and after the PCI operation and follow-up coronary angiography, serum creatinine levels, serum cystatin C were higher in in-stent restenosis group than those in non in-stent stenosis group patients (P<0.05); glomerular filtration rate was significantly lower than that in non in-stent restenosis group (P<0.05); Multivariate COX regression analysis showed that elevated serum creatinine levels, serum cystatin C, decline of glomerular filtration rate were the independent risk factors for in-stent restenosis in drug eluting stents. Conclusion The level of renal function is closely related to the occurrence of in-stent restenosis. The increase of serum creatinine, serum cystatin C and decrease of glomerular filtration rate are the independent risk factors for in-stent restenosis in drug eluting stents.

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杨天贵,付鹏,牛铁生.血清肌酐、胱抑素C及肾小球滤过率与支架内再狭窄的相关性[J].中国动脉硬化杂志,2017,25(8):818~822.

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  • 收稿日期:2016-12-01
  • 最后修改日期:2017-05-30
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  • 在线发布日期: 2017-07-12