Clinical Observation Of Serum CysC Levels Before And After PCI In Patients With Coronary Atherosclerotic Heart Disease And Diabetes Mellitus And/or Hypertension

Objectives:To evaluate the changes of serum cystatin C(CysC)levels before and after percutaneous coronary intervention(PCI)in Patients with coronary atherosclerotic heart disease(CHD)and Diabetes mellitus(DM)and/or hypertension(HP);to calculate and evaluate the incidence of contrast-induced nephropathy(CIN)after PCI in patients with CHD and DM and/or HP;analysis of the critical value of serum CysC in the diagnosis of CIN in CHD with DM and HP,on the basis of which the serum CysC and Scr are consistent with the diagnosis of CIN Conduct evaluation.Methods:227 Patients with CHD and DM and/or HP who underwent PCI in our hospital from October 2016 to May 2018 were enrolled in 4 groups,including 52 Patients with CHD alone.There were 74 Patients with CHD and HP,51 Patients with CHD and DM,and 50 Patients combined with CHD,HP and DM.The serum CysC value and Scr value of each patient before PCI and 72 hours after PCI were recorded.Statistical analysis the changes of CysC levels in each group and between groups before and after PCI.Calculate and evaluate The incidence of CIN in each group were calculated and evaluated.Calculate the critical value of CIN in the diagnosis of CysC in patients with CHD,HP and DM,and evaluate the consistency of CysC and Scr in diagnosis CIN.Results:1 There were significant differences in CysC values between patients with CHD and DM and/or HP in preoperative and postoperative(P<0.05).The CysC value were highest in Patients combined with CHD,HP and DM,followed by CHD with DM group,CHD with HP group,and simple CHD group.2 There were significant differences in CysC values between the Patients with CHD and DM and/or HP within each group before and after PCI(P<0.05).3 The incidence of CIN in patients with CHD and DM and/or HP was different(P<0.05).The group with the highest incidence rate is the CHD with HP and DM group(20.00%).4 Serum CysC and Scr in patients with CHD complicated with DM and HP were general consistency in the diagnosis of CIN.From the ROC curve we can know that it can diagnose CIN when the postoperative CysC value increased by 28.59%.The area under the curve was 92.5%,the sensitivity was 90.0%,specificity was 82.5%.Conclusions:1 Patients with CHD and DM and/or HP groups had different CysC levels before and after PCI.And the highest level of CysC is in the group of combined with CHD,HP and DM.2 The incidence of CIN in patients with CHD and DM and/or HP groups were different.The highest incidence rate is in the group of combined with CHD,HP and DM.(20.00%).3 The Serum CysC has a high diagnostic value for CIN.