中文摘要：

目的：评估血管紧张素转化酶抑制剂（ACEI）对经皮冠脉介入（PCI）术后造影剂肾病（CIN）的影响。方法：回顾性收集2013-2014年我院行PCI术患者421例,根据术前72 h是否使用ACEI类药物分为试验组（193例）和对照组（228例）。试验组患者术前72 h口服培哚普利4 mg,qd或盐酸贝那普利10 mg,qd;对照组患者术前未用ACEI类药物。观察两组患者血肌酐（Scr）、血尿素氮（BUN）及内生肌酐清除率估算值（eGFR）的变化及CIN发病率,并应用二元Logistics对CIN的影响因素作回归分析。结果：两组患者术前Scr、BUN、eGFR水平比较,差异无统计学意义（P〉0.05）。试验组患者术后Scr、BUN较术前明显升高,且显著高于对照组,差异有统计学意义（P〈0.05）;eGFR明显降低,但组间比较差异无统计学意义（P〉0.05）。试验组患者CIN发病率明显高于对照组（11.9%vs.4.4%）,差异有统计学意义（P〈0.05）。年龄、糖尿病、高血压、心力衰竭、肾病、造影剂量、术前使用ACEI为CIN发病率的独立危险因素（P〈0.05）。结论：ACEI类药物会造成PCI术后肾脏损害的加剧,同时提高了CIN发病率。

英文摘要：

OBJECTIVE：To evaluate the effects of angiotensin-converting enzyme inhibitor（ACEI）on the contrast-induced nephropathy（CIN）after percutaneous coronary intervention（PCI）.METHODS：421 patients underwent PCI were retrospectively collected from our hospital during 2013-2014.Those patients were divided into trial group（193 cases）and control group（228 cases）according to the use of ACEI within 72 h before surgery.Trial group was given perindopril 4 mg orally,qd,or benazepril hydrochloride 10 mg,qd,within 72 h before surgery;control group was not given ACEI before surgery.The changes of serum creatinine（Scr）,blood urea nitrogen（BUN）and estimation of glomerular filtration rate（eGFR）were observed in 2 groups,and influential factor of CIN was analyzed by using duality logistics.RESULTS：Before surgery,there was no statistical significance in Scr,BUN and eGFR between 2 groups（P〉0.05）.After operation,Scr and BUN of trial group was increased significantly and higher than those of control group,while eGFR of trial group was decreased significantly and lower than that of control group,with statistical significance（P〈0.05）.The incidence of CIN in trial group was significantly higher than in control group（11.9%vs.4.4%）,with statistical significance（P〈0.05）.The independent risk factors of CIN included age,diabetes mellitus,hypertension,heart failure,renal disease,radiography dose,the use of ACEI before surgery（P〈0.05）.CONCLUSIONS：The use of ACEI in percutaneous coronary radiography would be harmful to the renal function and would increase the incidence of CIN.