| Objective: Percutaneous coronary intervention(PCI)is a therapeutic method to dredge the narrow or isolated Coronary artery lumen by means of cardiac catheterization technique to improve myocardial perfusion.At present,PCI has become an important method of coronary revascularization and been widely applied in clinic for its rapid healing and good effect.In recent years,more and more research shows that contrast medium could cause different degree of renal injury especially the CHD patients with hypertension,diabetes and other high risk factors.People who accepted PCI have higher risks of contrast-induced renal injury.At present,renal function is mainly evaluated by serum creatine(Scr)measurement.But Scr is lack of sensibility for acute renal injury.Serum cyscatin-c(CysC)is one of the cysteine proteinase inhibitors with small molecular weight and steady formation rate,being expressed in all karyocytes.A mass of clinical researches all verify that CysC level can predict early renal function damage.The purpose of this study is to explore the effects of different dosage of contrast medium in PCI on the levels of CysC and Scr in CHD patients with hypertensions,by comparing the change of CysC and Scr levels before and after PCIMethods: A total of 145 CHD patients with hypertension were enrolled to the study from January to December in 2014 in Cangzhou Central Hospital.All of these patients were treated with PCI.According to different contrast medium in the PCI,all patients were divided into group A(?100ml),group B(101-150ml),group C(151-200ml),group D(201-250ml),group E(251-300ml)and group F(301-350ml).When admitted to hospital,all patients were kept records of general information such as gender,age,weight,height,blood pressure etc.Data were collected on fasting blood samples of 3-5 ml in the next morning,24 hours after PCI and 48 hours after PCI,The blood were to be tested in centrifuged serum Cys C and creatinine in clinical laboratory and data were recorded accordingly.Results: 1 The CysC levels,Scr levels and baseline clinical characteristic of the 5 groups before PCI were of no statistical significance(P>0.05).2.Comparison of CysC and Scr Level of Patients in Every Group 2.1 Comparison of CysC levels.2.1.1 24 hours after PCI,patients in group A,group B and group C had higher Cys C level than that of before the PCI and 48 hours after the PCI,with statistical significance(P<0.05).The difference between Cys C in 48 hours after PCI and before the PCI was of no statistical significance(P>0.05).2.1.2 24 hours and 48 hours after PCI,patients in group E had higher Cys-C than that of before the PCI and that of 48 hours after PCI was higher than that of 24 hours after PCI,with statistical significance(P<0.05).2.1.3 The difference of CysC levels of group F in different periods were of no statistical significance(P>0.05).2.1.4 24 hours after PCI,patients in group A,group B,group C,group D,group E had gradually increased CysC,with no statistical significance(P>0.05)and patients in group F had lower CysC than patients in group A,group B,group C,group D,group E,with statistical significance(P<0.05).48 hours after PCI,patients in group A,group B,group C,group D,group E had gradually increased CysC level and the CysC level in group E is higher than that in group A,group B,group C and group D,with statistical significance(P<0.05).48 hours after PCI,patients in group F had higher CysC than patients in group A and group B,with no statistical significance(P>0.05)and patients in group F had lower Cys C than patients in group C,group D and group E,but comparing with that in group C and group D,with no statistical significance(P>0.05)while comparing with that in group E,with statistical significance(P<0.05).2.2 Comparison of Scr Level 2.2.1 24 hours and 48 hours after PCI,patients in group A,group B,group C,group D,group E had lower Scr levels than that of before the PCI,with no statistical significance(P>0.05).24 hours and 48 hours after PCI,patients in group F had lower Scr leves than that before the PCI,with statistical significance(P<0.05).2.2.2 24 hours after PCI,patients in group A,group B,group C,group D,group E had gradually increased Scr levels,with no statistical significance(P>0.05).24 hours after PCI,patients in group F had lower Scr leves than patients in group A,group B,group C,group D,group E,with statistical significance(P<0.05).48 hours after PCI,patients in group A,group B,group C,group D,group E had gradually increased Scr,with no statistical significance(P>0.05)in comparison among groups.48 hours after PCI,patients in group F had lower Scr than patients in group A,group B,group C,group D,group E,with statistical significance(P<0.05).Conclusion:1 As the increase of contrast medium in PCI surgery,CysC level rises.2 Prediction of Cys C level towards early renal damage is superior to Scr. |
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