PCI前后血管生成素-2水平与急性心梗伴CKD患者肾功能指标的相关性

迪力木拉提·阿不来提; 买尔哈巴; 穆叶赛·尼加提

doi:10.13201/j.issn.1009-5918.2021.08.004

PCI前后血管生成素-2水平与急性心梗伴CKD患者肾功能指标的相关性

- 1. 新疆维吾尔自治区人民医院新疆急救中心(乌鲁木齐, 830000);
- 2. 新疆医科大学第一附属医院综合内四科
基金项目:
新疆维吾尔自治区自然科学基金项目(No:2018D01C325)

详细信息

通讯作者: 穆叶赛·尼加提,E-mail:anyanll@163.com

中图分类号: R542.22

收稿日期: 2021-05-29

Correlation between angiopoietin-2 levels before and after PCI and renal function indexes in patients with acute myocardial infarction and CKD

- 1. Xinjiang Emergency Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830000, China;
- 2. The Fourth Department of General Internal Medicine, the First Affiliated Hospital of Xinjiang Medical University

More Information

Corresponding author: Muyesai Nijiati, E-mail: anyanll@163.com

Received Date: 29 May 2021

摘要

摘要: 目的:探讨急性心肌梗死(AMI)伴慢性肾脏病(CKD)患者行经皮冠状动脉介入(PCI)前后血管生成素-2(Ang-2)水平与肾功能指标的相关性。方法:纳入2018年4月—2020年5月期间我院收治的行PCI治疗的AMI伴CKD患者56例,设为CKD组;另选取同期行PCI治疗的不伴CKD的AMI患者60例设为对照组;收集两组患者临床资料、实验室指标;分别于患者入院时、PCI术后24~48 h内测定血清Ang-2水平,于入院时、PCI术后72 h测定患者肾功能指标[血清肌酐(Scr)、尿素氮(BUN)、估计肾小球滤过率(eGFR)];采用Spearman线性方程分析PCI前后Ang-2水平与肾功能指标的相关性。结果:(1)组内比较,入院时CKD组Scr、BUN水平高于PCI术后72 h, eGFR水平低于PCI术后72 h,差异具有统计学意义(P<0.05);对照组PCI治疗前后Scr、BUN、eGFR水平比较差异无统计学意义(P>0.05);(2)入院时两组患者Ang-2水平比较差异无统计学意义(P<0.05);PCI术后CKD组Ang-水平与入院时差异无统计学意义(P>0.05),对照组Ang-2水平明显降低(P<0.05),PCI术后CKD组Ang-2水平高于对照组(P<0.05);(3) Pearson线性相关性分析显示,CKD组入院时Ang-2水平与Scr、BUN、eGFR无明显相关性(r=0.012、0.000、0.009,P>0.05),PCI术后CKD组Ang-2水平与Scr、BUN水平呈正相关(r=0.588、0.564,P<0.05),与eGFR呈负相关(r=-0.799,P<0.05)。结论:PCI术后血清Ang-2水平与肾功能指标显著相关,有可能成为早期预测造影剂肾病的新生物学标志物。
- 血管生成素-2 /
- 急性心肌梗死 /
- 慢性肾脏病 /
- 肾功能 /
- 相关性
Abstract: Objective: To investigate the correlation between angiopoietin-2 levels and renal function indexes in patients with acute myocardial infarction and chronic kidney disease before and after PCI.Methods: Fifty-six patients with acute myocardial infarction and chronic kidney disease who underwent percutaneous coronary intervention in our hospital from April 2018 to May 2020 were enrolled and set as the CKD group; In addition, 60 AMI patients without CKD who underwent PCI during the same period were selected as the control group; Collect clinical data and laboratory indicators of two groups of patients; Serum Ang-2 levels were measured on admission and within 24 to 48 hours after PCI, and renal function indicators(serum creatinine, urea nitrogen, and estimated glomerular filtration rate) were determined on admission and 72 hours after PCI; Spearman linear equation was used to analyze the correlation between Ang-2 levels and renal function indexes before and after PCI.Results:(1)Compared within the group, levels of Scr and BUN in the CKD group were higher than 72 hours after PCI, and level of eGFR was lower than 72 hours after PCI, the difference was statistically significant(P<0.05); There was no significant difference in Scr, BUN, eGFR levels before and after PCI treatment in the control group(P>0.05).(2)There was no significant difference in the Ang-2 level between the two groups of patients on admission(P<0.05).There was no significant difference between the Ang-level of the CKD group after PCI and the time of admission(P>0.05). The Ang-2 level of the control group was significantly reduced(P<0.05). The Ang-2 level of the CKD group after PCI was higher than that of the control group(P<0.05).(3)Pearson linear correlation analysis showed that there was no significant correlation between Ang-2 level and Scr, BUN, eGFR at admission in the CKD group(r=0.012, 0.000, 0.009, P>0.05). Ang-2 level in CKD group after PCI was positively correlated with Scr and BUN levels(r=0.588, 0.564, P<0.05), and negatively correlated with eGFR(r=-0.799, P<0.05).Conclusion: The serum Ang-2 level after PCI is significantly correlated with renal function indicators, and may become a new biomarker for early prediction of contrast-induced nephropathy.
- angiopoietin-2 /
- acute myocardial infarction /
- chronic kidney disease /
- renal function /
- correlation

HTML全文

参考文献(20)

[1]	Bontekoe J,Lee J,Bansal V,et al.Biomarker Profiling in Stage 5 Chronic Kidney Disease Identifies the Relationship between Angiopoietin-2 and Atrial Fibrillation[J].Clin Appl Thromb Hemost,2018,24(9_suppl):269S-276S.
[2]	刘少平,张海,胡亚华,等.外周血血管生成素-2mRNA定量表达与食管癌侵袭转移及预后的关系[J].临床消化病杂志,2018,30(4):210-213.
[3]	Jian W,Mo CH,Yang GL,et al.Angiopoietin-2 provides no incremental predictive value for the presence of obstructive coronary artery disease over N-terminal pro-brain natriuretic peptide[J].J Clin Lab Anal,2019,33(8):e22972.
[4]	陈德珠,朱满桂,张东,等.ICU患者发生急性肾损伤对远期心血管疾病的影响[J].临床急诊杂志,2019,20(12):946-950.
[5]	刘亚慧,朱彬彬,高传玉.冠心病患者中慢性肾脏病的患病情况及影响因素分析[J].临床心血管病杂志,2020,36(1):36-39.
[6]	刘子龙,吴铮,孙礼玲,等.血清血管生成素2、肾胺酶水平与急性心肌梗死患者经皮冠状动脉介入术后3年预后的关系研究[J].实用心脑肺血管病杂志,2019,27(7):12-17.
[7]	Kidney disease:improving global outcomes(KDIGO)blood pressure work group.KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease[J].Kidney int,2012,2(5):337-414.
[8]	中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380-393.
[9]	中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.
[10]	Raptis V,Bakogiannis C,Loutradis C,et al.Levels of Endocan,Angiopoietin-2,and Hypoxia-Inducible Factor-1a in Patients with Autosomal Dominant Polycystic Kidney Disease and Different Levels of Renal Function[J].Am J Nephrol,2018,47(4):231-238.
[11]	刘建光,姜红梅,王峥,等.影响脑血管造影介入术后患者发生造影剂致急性肾损伤的相关因素分析[J].临床急诊杂志,2016,17(5):358-360.
[12]	David S,Kümpers P,Lukasz A,et al.Circulating angiopoietin-2 levels increase with progress of chronic kidney disease.Nephrol Dial Transplant,2010,25(8):2571-2576.
[13]	娜尔给扎·艾尔肯,胡力哈尔·拜合提亚尔,布娃加·吾守尔.脂联素,血管紧张素Ⅱ血液水平及其基因多态性与新疆维吾尔族原发性高血压的相关性研究[J].临床心血管病杂志,2020,36(12):5.
[14]	Desjardins MP,Thorin-Trescases N,Sidibé A,et al.Levels of Angiopoietin-Like-2 Are Positively Associated With Aortic Stiffness and Mortality After Kidney Transplantation.Am J Hypertens,2017,30(4):409-416.
[15]	李昌盛,常婵,戴河柳,等.血管外肺水指数、血管生成素-2在脓毒症合并急性呼吸窘迫综合征患者预后评估中的价值[J].内科急危重症杂志,2018,24(5):372-374.
[16]	陈晓涛,郑峰.老年骨肉瘤患者血清中血管内皮生长因子和血管生成素-2表达及其相关因素分析[J].中国临床药理学杂志,2019,35(17):1848-1850.
[17]	Tsai YC,Lee CS,Chiu YW,et al.Angiopoietin-2 as a Prognostic Biomarker of Major Adverse Cardiovascular Events and All-Cause Mortality in Chronic Kidney Disease[J].PLoS One,2015,10(8):e0135181.
[18]	Jian W,Li L,Wei XM,et al.Serum angiopoietin-2 concentrations of post-PCI are correlated with the parameters of renal function in patients with coronary artery disease[J].Medicine(Baltimore),2019,98(1):e13960.
[19]	Chen SM,Li D,Xing X,et al.Higher serum angiopoietin 2 levels are independently associated with coronary microvascular dysfunction in patients with angina in the absence of obstructive coronary artery disease[J].Chin Med J(Engl),2020,133(14):1662-1668.
[20]	张庆燕,蒋春明,邵秋媛,等.维生素D缺乏与慢性肾脏病患者血管内皮细胞功能异常的相关性研究[J].临床肾脏病杂志,2018,18(4):215-219.