祁兴敏, 安惠旒, 王瑞, 曹炜红, 焦霞, 王世杰, 于改革. UACR联合血清KIM-1、NGAL对冠心病病人术后并发造影剂肾病的预测分析[J]. 蚌埠医学院学报, 2023, 48(2): 178-181. DOI: 10.13898/j.cnki.issn.1000-2200.2023.02.009
    引用本文: 祁兴敏, 安惠旒, 王瑞, 曹炜红, 焦霞, 王世杰, 于改革. UACR联合血清KIM-1、NGAL对冠心病病人术后并发造影剂肾病的预测分析[J]. 蚌埠医学院学报, 2023, 48(2): 178-181. DOI: 10.13898/j.cnki.issn.1000-2200.2023.02.009
    QI Xing-min, AN Hui-liu, WANG Rui, CAO Wei-hong, JIAO Xia, WANG Shi-jie, YU Gai-ge. Predictive analysis of UACR combined with serum KIM-1 and NGAL on postoperative contrast-induced nephropathy in patients with coronary heart disease[J]. Journal of Bengbu Medical College, 2023, 48(2): 178-181. DOI: 10.13898/j.cnki.issn.1000-2200.2023.02.009
    Citation: QI Xing-min, AN Hui-liu, WANG Rui, CAO Wei-hong, JIAO Xia, WANG Shi-jie, YU Gai-ge. Predictive analysis of UACR combined with serum KIM-1 and NGAL on postoperative contrast-induced nephropathy in patients with coronary heart disease[J]. Journal of Bengbu Medical College, 2023, 48(2): 178-181. DOI: 10.13898/j.cnki.issn.1000-2200.2023.02.009

    UACR联合血清KIM-1、NGAL对冠心病病人术后并发造影剂肾病的预测分析

    Predictive analysis of UACR combined with serum KIM-1 and NGAL on postoperative contrast-induced nephropathy in patients with coronary heart disease

    • 摘要:
      目的探讨尿微量白蛋白/尿肌酐比值水平(urine micro-albumin/urinary creatinine ratio,UACR)联合血清肾损伤分子-1(kidney injury molecule-1,KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)对冠心病病人术后并发造影剂肾病(contrast-induced nephropathy,CIN)的评估价值。
      方法选取162例冠心病病人,均行冠状动脉造影、经皮冠状动脉介入术,根据术后是否发生CIN分为CIN组(22例)、非CIN组(140例)。比较2组病人临床基线资料以及术后24 h的UACR、血清KIM-1、NGAL水平,采用多因素logistic回归分析CIN发生的危险因素,采用受试者工作特征曲线(ROC曲线)分析UACR、KIM-1、NGAL预测CIN的诊断价值。
      结果CIN病人术后24 h的NGAL、血清KIM-1、UACR水平以及术前尿肌酐均高于非CIN组,而术前肾小球滤过率低于对照组,差异有统计学意义(P < 0.05~P < 0.01)。多因素logistic回归分析显示,UACR、KIM-1、NGAL升高均是CIN发生的危险因素(P < 0.01)。ROC曲线分析显示,NGAL、KIM-1、UACR以及联合诊断预测CIN的曲线下面积分别为0.826、0.801、0.790、0.886,联合诊断的曲线下面积明显高于单独诊断,差异有统计学意义(P < 0.05)。
      结论UACR以及血清KIM-1、NGAL是冠心病病人术后发生CIN的独立危险因素,发生CIN的高风险病人各指标均处于较高水平,三种指标联合检测可提高CIN的预测价值。

       

      Abstract:
      ObjectiveTo investigate the evaluation value of urine micro-albumin/urinary creatinine ratio(UACR) combined with serum kidney injury molecule-1(KIM-1) and neutrophil gelatinase-associated lipocalin(NGAL) on postoperative contrast-induced nephropathy(CIN) in patients with coronary heart disease.
      MethodsOne hundred and sixty-two patients with coronary heart disease were selected.All patients underwent coronary angiography and percutaneous coronary intervention.According to the occurrence of CIN after operation, they were divided into CIN group(22 cases) and non-CIN group(140 cases).The baseline data, UACR, serum KIM-1 and NGAL levels at 24 h after operation were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors of CIN.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of UACR, KIM-1 and NGAL in predicting CIN.
      ResultsThe levels of NGAL, serum KIM-1, UACR and preoperative UCr of CIN patients 24 h after operation were significantly higher than those in non-CIN group, while preoperative eGFR was significantly lower than that in control group(P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that the increased levels of UACR, KIM-1, NGAL were the risk factor for CIN(P < 0.01).ROC curve analysis showed that the area under the curve for NGAL, KIM-1, UACR and the combined diagnosis to predict CIN were 0.826, 0.801, 0.790, 0.886, the area under the curve of the combined diagnosis to predict CIN was significantly higher than that in the single diagnosis(P < 0.05).
      ConclusionsUACR, serum KIM-1 and NGAL are the independent risk factors for CIN in patients with coronary heart disease after surgery.High-risk patients with CIN are all at a high level in UACR, serum KIM-1 and NGAL.The combined prediction of the three indicators can improve the predictive value of CIN.

       

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