The Association Of The Expression Of Plasma Endothelial Microparticle With Contrast-Induced Nephropathy In Patients With Coronary Angiography

Objective:To test the association of the expression of plasma endothelial microparticle with contrast-induced nephropathy of patients with coronary angiography.Method: 180 patients with chest pain after coronary angiography were enrolled from Second Affiliated Hospital of Dalian Medical University from November 2017 to November 2018.These patients were treated with isotonic iodixatol(100ml:65.2g)produced by Jiangsu Hengrui,and the dose of contrast agent was recorded.We also recorded the patients’ ages,sex,BMI,history of hypertension,history of diabete,history of coronary heart disease,history of smoking,medical history,history of the rehydration therapy,N-terminal pro-brain natriurelic peptide(NT-proBNP)level,hypersensitive Creactive protein(hs-CRP)level,hydration-6(IL-6)level,uric acid(UA)level,Serum,creatinine(Scr)level,serum urea nitrogen(BUN)level,blood routine,blood lipid level and blood biochemical index.Flow cytometry was used to analyze the expression of the endothelial microparticle.The patients were divided into 2 groups including normal renal function group(n=128)and the renal impairment group(n=52).Further according to the degree of renal impairment,the 52 patients were divided into eGFR < 60 group(n=10)and 60≤eGFR < 90 group(n=42).Postoperative expression of EMP and serum creatinine were detected in 117 patients.The 117 patients were divided into the CIN group(n=6)and non CIN group(n=111)according to the diagnostic criteria of CIN.Compare the differences of the expression of plasma endothelial microparticle among each group,and preoperative and postoperative.Analyze the expression of plasma endothelial microparticle in peripheral blood and the correlation with the contrast-inducednephropathy of patients with coronary angiography.SPSS 23.0 software was used for statistical analysis.Results: 1.The expression of plasma endothelial microparticle and the serum hs-CRP were significantly higher in renal impairment group than those in normal renal function group(P<0.05).The serum IL-6 was higher in renal impairment group than that in normal renal function group,but there is no significant difference between the two groups(P>0.05).2.The expression of endothelial microparticle and the serum hs-CRP were significantly higher in eGFR<60 group than those in 60≤eGFR<90 group(P<0.05).The serum IL-6 was higher in eGFR<60 group than that in 60≤eGFR<90 group,but there is no significant difference between the two groups(P>0.05).3.Spearman correlation showed that the expression of EMP was negatively correlated with eGFR(r=-0.201,P<0.01)。4.Expression of endothelial microparticle and serum creatinine were detected in 117 patients after the operation.Six patients developed CIN.The incidence of CIN was 5.1%.The incidence of CIN in eGFR>90 group was2.6%,60≤eGFR<90 group was 6.6%,eGFR<60 group was 22.2%.The incidence of CIN was significantly different in eGFR>90 group 、60≤eGFR<90 group and eGFR<60 group different renal function groups(P<0.05).The incidence of CIN in eGFR<60 group was significantly higher than in eGFR≥90 group(P<0.05).5.The serum hs-CRP、Cys-C、UA were significantly higher in CIN group than that in the non CIN group.The eGFR is significantly lower in CIN group than that in the non CIN group(P<0.05).Patients(eGFR<60)without the rehydration therapy were prone to get CIN(P < 0.05).6.The expression of the endothelial microparticle in postoperative and the difference of the expression of endothelial microparticle between postoperative and preoperative were significantly higher than the CIN group than those in non CIN group(P<0.05).7.Spearman correlation showed that the expression of EMP was positively correlated with serum IL-6(r=0.393,P<0.01).The expression of EMP was positively correlated with serum hs-CRP(r=0.360,P<0.01).8.Logistic regression analysis showed that: the level of NT-proBNP、eGFR、UA、Cys-C were correlated with the incidence of contrast induced nephropathy.Conclusion: 1.The expression of plasma endothelial microparticle was higher in renal impairment group,the increase was more obvious in patients with severe renal impairment,suggesting that the high expression of plasma EMP was associated with renal insufficiency.2.In this study,the incidence of CIN was 5.1%,which would be even higher in patients with renal impairment of preoperative.In patients with contrast-inducednephropathy,the plasma endothelial microparticle levels were significantly increased after coronary angiography.The expression of plasma endothelial microparticle may play a role in the occurrence of contrast-induced-nephropathy.