摘要
目的探讨血清β2微球蛋白(β2-MG)联合胱抑素-C(Cys-C)在预测经皮冠状动脉介入(PCI)术后对比剂肾病(CIN)的临床意义。方法选取2020年8月至2022年7月在广西壮族自治区民族医院行PCI治疗的120例肾功能轻中度受损患者作为研究对象,在PCI术前及术后检测血清指标血清肌酐(SCr)、β2-MG、Cys-C,估算肾小球滤过率(eGFR),计算SCr/β2-MG、SCr/Cys-C及β2-MG/Cys-C比值,根据PCI术前和术后SCr的变化情况,将患者分为非CIN组和CIN组,通过分析两组患者血清β2-MG及Cys-C的差异进而分析其在PCI术后CIN的预测价值。结果CIN发生率为19.17%(23/120)。CIN组和非CIN组术前eGFR差异无统计学意义(P>0.05)。CIN组的血清β2-MG和Cys-C水平显著高于正常组,术前β2-MG/Cys-C比值显著大于非CIN组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,术后SCr与术前β2-MG、Cys-C、β2-MG/Cys-C呈正相关(P<0.05),与术前eGFR、SCr/β2-MG比值、SCr/Cys-C比值呈负相关(P<0.05)。多因素logistic回归分析提示,术前β2-MG/Cys-C比值的升高是PCI术后CIN的危险因素(OR=15.988,P<0.05)。术前β2-MG、SCr以及β2-MG/SCr三者联合预测PCI术后发生CIN的曲线下面积(AUC)值为0.900(95%CI:0.845~0.955),三者分别预测CIN的AUC值分别为0.544、0.520和0.672。结论血清β2-MG和Cys-C作为评价CIN患者肾功能的早期生物标志物,联合使用这两者可以提升对PCI术后CIN的预测精度。
Objective To investigate the clinical significance of serumβ2-microglobulin(β2-MG)combined with cystatin-C(Cys-C)in predicting contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI).Methods A total of 120 patients with mild or moderate renal impairment who underwent PCI in Guangxi Zhuang Autonomous Region Ethnic Hospital from August 2020 to July 2022 were selected as the research objects.Serum creatinine(SCr),β2-MG and Cys-C were detected before and after PCI,glomerular filtration rate(eGFR)was estimated,and the ratios of SCr/β2-MG,SCr/Cys-C andβ2-MG/Cys-C were calculated.According to the changes of SCr before and after PCI operation,patients were divided into the non-CIN group and the CIN group.By analyzing the differences of serumβ2-MG and Cys-C between the two groups of patients,the predictive value of CIN after PCI operation was analyzed.Results The incidence of CIN was 19.17%(23/120).Before operation,there was no statistically significant difference in eGFR between the CIN group and the non-CIN group(P>0.05).Serumβ2-MG and Cys-C levels in the CIN group were obviously higher than those in the non-CIN group,and the ratio ofβ2-MG/Cys-C before operation was obviously higher than that in the non-CIN group,with statistically significant differences(P<0.05).It was shown by Pearson correlation analysis that postoperative SCr was positively correlated with preoperativeβ2-MG,Cys-C andβ2-MG/Cys-C(P<0.05),and it was negatively correlated with preoperative eGFR,SCr/β2-MG ratio and SCr/Cys-C ratio(P<0.05).It was indicated by multivariate logistic regression analysis that the increase of preoperativeβ2-MG/Cys-C ratio was a risk factor for CIN after PCI operation(OR=15.988,P<0.05).The area under ROC curve(AUC)value of preoperativeβ2-MG,SCr andβ2-MG/SCr combined to predict CIN after PCI was 0.900(95%CI:0.845-0.955),and the AUC value of preoperativeβ2-mg/SCR was 0.544,0.520 and 0.672,respectively.Conclusion Serumβ2-MG and Cys-C are used as early biomarkers to evaluate the renal function
作者
雷玲艳
邝日禹
曾凤兰
李依阳
覃凯
耿思远
苏晓琳
LEI Lingyan;KUANG Riyu;ZENG Fenglan;LI Yiyang;QIN Kai;GENG Siyuan;SU Xiaolin(Department of Cardiovascular Medicine,Minzu Hospital of Guangxi Zhuang Autonomous Region,Affiliated Minzu Hospital of Guangxi Medical University,Guangxi,Nanning 530001,China)
出处
《中国医药科学》
2024年第21期190-194,共5页
China Medicine And Pharmacy
基金
广西壮族自治区卫生健康委员会科研课题(Z20190678)。
