摘要
目的探讨术前24 h血清胱抑素C(CysC)及超敏C反应蛋白(hs-CRP)对经皮冠状动脉介入术(PCI)后造影剂肾病的预测价值。方法选取2019年6月—2020年3月在河北中石油中心医院行PCI治疗的128例冠状动脉硬化性心脏病(以下简称冠心病)患者为研究对象,根据术后造影剂肾病诊断结果,将其分为病例组(23例)和对照组(105例)。采用全自动生化分析仪测定两组术前24 h血清CysC、hs-CRP水平。采用Logistic回归分析患者PCI术后造影剂肾病的危险因素,通过绘制受试者工作特征(ROC)曲线评价术前24 h血清CysC、hs-CRP及两者联合对造影剂肾病的预测价值。结果病例组造影剂用量、合并糖尿病患者比例、术前24 h血清CysC及hs-CRP水平高于对照组(P<0.05)。多因素Logistic回归分析显示,造影剂用量高[O^R=1.843(95%CI:1.322,2.758)]、合并糖尿病[O^R=0.645(95%CI:0.510,0.892)]、术前24 h血清CysC升高[O^R=1.801(95%CI:1.139,2.448)]、术前24 h血清hs-CRP升高[O^R=0.633(95%CI:0.479,0.880)]是PCI术后发生造影剂肾病的独立危险因素(P<0.05)。术前24 h血清CysC(>1.322 mg/L)联合hs-CRP(>5.290 mg/L)预测造影剂肾病的AUC最高,为0.916(95%CI:0.897,0.986),敏感性为91.3%(95%CI:0.883,0.936),特异性为82.9%(95%CI:0.795,0.850)。结论PCI术后造影剂肾病的发生与造影剂用量、合并糖尿病情况及术前24 h血清CysC、hs-CRP水平有关。术前24 h血清CysC、hs-CRP对PCI术后造影剂肾病具有较高的预测价值。
Objective To investigate the predictive value of preoperative cystatin C(CysC) and highsensitivity C-reactive protein(hs-CRP) in the occurrence of contrast-induced nephropathy after percutaneous coronary intervention(PCI). Methods One hundred and twenty-eight patients with coronary heart disease who underwent PCI in our hospital from June 2019 to March 2020 were selected. According to whether the patients were diagnosed with contrast-induced nephropathy after the operation, they were divided into case group(n =23) and control group(n =105). The baseline data of the two groups were compared, and the serum CysC and hs-CRP levels were measured by automatic biochemical analyzer. Logistic regression was used to analyze the influencing factors for the occurrence of contrast-induced nephropathy after PCI. The predictive value of serum CysC, hs-CRP and their combination in the occurrence of contrast-induced nephropathy was evaluated via receiver operating characteristic(ROC) curve. Results In case group, the proportion of diabetic patients, the dosage of contrast medium, and the levels of CysC and hs-CRP 24 hours before operation were higher than those in control group(P < 0.05). Logistic regression analysis showed that high dosage of contrast medium [O^R= 1.843(95% CI: 1.322, 2.758)], complication with diabetes mellitus [O^R= 0.645(95% CI: 0.510, 0.892)], increased CysC 24 hours before operation [O^R= 1.801(95% CI: 1.139, 2.448)], and elevated hs-CRP 24 hours before operation [O^R= 0.633(95% CI: 0.479, 0.880)] were the influencing factors for the occurrence of contrast-induced nephropathy after PCI(P < 0.05). Area under the ROC curve(AUC) of the combination of CysC(> 1.322 mg/L) and hs-CRP(> 5.290 mg/L) 24 hours before operation was the highest in predicting contrast-induced nephropathy, which was 0.916(95% CI: 0.897, 0.986). The sensitivity was91.3%(95% CI: 0.883, 0.936), and the specificity was 82.9%(95% CI: 0.795, 0.850). Conclusions The incidence of contrast-induced nephropathy after PCI was correlated with dosage o
作者
麦李明
杨洁
吴楠
裴静
Li-ming Mai;Jie Yang;Nan Wu;Jing Pei(Department of Nephrology,Hebei Petro China Central Hospital,Langfang,Hebei 065000,China)
出处
《中国现代医学杂志》
CAS
北大核心
2021年第2期19-23,共5页
China Journal of Modern Medicine
基金
廊坊市科技支撑计划项目(2019013013)。
