The Relationship Between Preoperative Non High Density Lipoprotein Cholesterol Level And Contrast Induced Nephropathy In Patients Undergoing Percutaneous Coronary Intervention

Purpose:By studying the relationship between preoperative non-HDL-C levels and the occurrence of contrast induced nephropathy(CIN)in patients undergoing percutaneous coronary intervention(PCI),In order to find new risk factors for CIN,and early recognition of CIN high-risk groups.Method:A total of 450 coronary heart disease patients undergoing PCI who were hospitalized in our department from October 2015 to April 2017 were collected.Record all the general conditions,past medical history,current medical history,medication history and allergy history of the selected patients,and improve preoperative routine examinations,including blood lipid levels and renal function.Four hours before surgery,the patient was given 0.9% sodium chloride injection at a rate of 1 ml/kg/h for continuous intravenous hydration,followed by PCI,and hydration was continued for 24 hours following the above procedure and intravenous furosemide 20 mg was given.Renal function and other indicators were measured 48 hours after surgery.According to the accepted diagnostic criteria of CIN,it is divided into CIN group and non-CIN group.And the difference between the clinical baseline data between the two groups was compared.Patients were divided into 4 groups based on their quartiles of non-HDL-C levels,and whether there was a difference in clinical baseline and CIN rates between the 4 groups.Finally,Logistic regression analysis was used to examine whether non-LDL-C level was a risk factor for CIN.P<0.05 was considered statistically significant.Result:1.Of the 450 patients included in the study,comparison of clinical baseline levels between CIN and non-CIN patients,differences in clinical baseline levels between the two groups were statistically significant in terms of non-HDL-C levels,contrast medium type,and ejection fraction;gender,age,history of hypertension,history of diabetes,Other history of kidney disease,smoking,acute cardiac infarction,contrast medium usage,TC levels,TG levels,LDL-C levels,HDL-C levels,APo A levels,APoB levels,and Lp(a)levels did not reach statistical significance.2.Four quartiles of non-HDL-C levels were grouped,4 groups of patients were statistically different in TC level,TG level,LDL-C level,and Apo B level;in gender,age,history of hypertension,history of diabetes,history of other kidney diseases,smoking,acute myocardial infarction,ejection fraction,contrast agent type,contrast medium dosage,HDL-C level,ApoA level,Lp(a)level did not reach statistical difference.3.Among the 4 groups obtained after the non-HDL-C level quartile grouping,the chi-square test was used to compare their morbidity,P=0.014<0.05,ie,the difference in the incidence rate between the four groups was statistically significant.4.Logistic regression analysis was used to investigate the relationship between non-HDL-C levels and the pathogenesis of CIN.The OR value was 1.798,95% CI(1.074,3.011),and P=0.026<0.05,indicating that non-HDL-C levels were elevated risk factors for CIN onset.Conclusion:Preoperative non-HDL-C levels in PCI patients are related to the incidence of CIN.The increase of non-HDL-C level is one of the risk factors for the development of CIN.