摘要
目的探讨血清小而密低密度脂蛋白(sd-LDL)在急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉支架介入(PCI)术后发生对比剂肾病(CIN)的预测价值。方法连续选取2019年11月至2020年8月因急性ST段抬高型心肌梗死于徐州医科大学附属医院心内科行急诊PCI的患者352例为研究对象,根据术后是否发生CIN,分为CIN组(n=71)及非CIN组(n=281)。所有研究对象术前检测血清sd-LDL。比较两组患者的临床资料及不同血清水平的sd-LDL患者CIN的发生率,绘制ROC曲线评价sd-LDL对STEMI接受急诊PCI患者术后发生CIN的预测价值,采用Logistic回归分析研究STEMI行急诊PCI患者术后CIN的影响因素。结果CIN组的血清sd-LDL水平高于非CIN组,差异具有统计学意义(P<0.05)。ROC曲线显示,sd-LDL预测STEMI患者接受急诊PCI后发生CIN的曲线下面积(AUC)为0.741,最佳截断为1.201,灵敏度为72.9%,特异性为83.5%。结论血清sd-LDL水平升高是STEMI患者急诊PCI后发生CIN的独立危险因素。术前sd-LDL水平对预测急诊PCI后对比剂肾病的发生具有一定的临床意义。
Objective To investigate the predictive value of serum small dense low-density lipoprotein(sd-LDL)in the development of contrast induced nephropathy(CIN)after emergency percutaneous coronary stenting(PCI)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 352 consecutive patients who underwent emergency PCI due to acute ST segment elevation myocardial infarction at the Department of Cardiology,Xuzhou Medical University Hospital between November 2019 and August 2020 were enrolled and divided into CIN(n=71)and non CIN(n=281)groups according to whether the patients developed CIN postoperatively.Serum sd-LDL was measured preoperatively in all study subjects.Clinical data and the incidence of CIN in patients with sd-LDL in different serum levels were compared between the two groups,ROC curves were drawn to evaluate the predictive value of sd-LDL for the development of CIN after PCI in patients with STEMI undergoing emergency PCI,and logistic regression was used to study the influencing factors of CIN after PCI in patients with STEMI undergoing emergency PCI.Results The serum SD LDL levels in CIN group were higher than those in non CIN group,and the differences were statistically significant(P<0.05).The ROC curve showed that sd-LDL predicted the occurrence of CIN after undergoing emergency PCI in STEMI patients with an area under the curve(AUC)of 0.741 and the optimal cutoff was 1.201,with a sensitivity of 72.9%and specificity of 83.5%.Conclusion Increased serum sd-LDL levels are independent risk factors for the development of CIN after emergency PCI in STEMI patients.Preoperative SD LDL levels have some clinical significance in predicting the occurrence of contrast induced nephropathy after emergency PCI.
作者
李雨涵
马凯
郑迪
轩永丽
李文华
Li Yuhan;Ma Kai;Zheng Di;Xuan Yongli;Li Wenhua(Department of Cardiology,Xuzhou Medical University,Xuzhou 221004,China;不详)
出处
《中国循证心血管医学杂志》
2021年第12期1534-1537,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
小而密低密度脂蛋白
对比剂肾病
急性心肌梗死
Small dense low density lipoprotein
Contrast induced nephropathy
Acute myocardial infarction
