摘要
目的探讨血清半乳糖集素-3(Gal-3)、胱抑素C(CysC)水平预测急性心肌梗死(AMI)冠状动脉介入术(PCI)后急性肾损伤(AKI)的价值。方法回顾性分析2018年5月至2023年2月郑州大学第二附属医院内科重症监护室行急诊PCI术的90例AMI患者临床资料,经过多因素logistic回归分析,明确AMI患者PCI术后发生AKI的危险因素。结果依据AKI的诊断标准进行分组,分为AKI组(20例)和非AKI组(70例)。AKI组患者高血压、糖尿病、术前使用血管紧张素转化酶抑制剂(ACEI)、血肌酐>100μmol·L^(-1)占比高于非AKI组,差异有统计学意义(P<0.05);AKI组患者血清Gal-3、CysC水平高于非AKI组,差异有统计学意义(P<0.05)。经受试者工作特征曲线分析显示,血清Gal-3、CysC水平均能预测AMI患者PCI术后AKI的发生,曲线下面积分别为0.854、0.917(P<0.05)。经多因素logistic回归分析显示,高血压、糖尿病、术前使用ACEI、血肌酐>100μmol·L^(-1)、Gal-3≥95.840 ng·L^(-1)、CysC≥1.330 mg·L^(-1)为AMI患者PCI术后发生AKI的危险因素(P<0.05)。结论急诊PCI术前检测血清Gal-3、CysC水平对AMI患者术后AKI的发生有较高的预测价值,且敏感度和特异度均较高。
Objective To explore the value of serum galactose-3(Gal-3)and cystatin C(CysC)levels in predicting acute kidney injury(AKI)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Retrospective analysis of the clinical data of 90 AMI patients who underwent emergency PCI surgery in the internal medicine intensive care unit of the Second Affiliated Hospital of Zhengzhou University from May 2018 to February 2023,After multiple logistic regression analysis,identified the risk factors for AKI in AMI patients after PCI.Results According to the diagnostic criteria of AKI,the patients were grouped into AKI group(20 cases)and non AKI group(70 cases).The proportion of hypertension,diabetes,preoperative angiotensin-converting enzyme inhibitor(ACEI)and serum creatinine>100μmol·L^(-1) in AKI group were higher than that in non AKI group(P<0.05).The serum levels of Gal-3 and CysC in the AKI group were higher than those in the non AKI group(P<0.05).Receiver operating characteristic curve analysis showed that serum Gal-3 and CysC levels could predict the occurrence of AKI in AMI patients after PCI,with areas under the curve of 0.854 and 0.917,respectively(P<0.05).Multifactor logistic regression analysis showed that hypertension,diabetes,preoperative use of ACEI,and serum creatinine>100μmol·L^(-1),Gal-3≥95.840 ng·L^(-1),CysC≥1.330 mg·L^(-1) were risk factors for AKI in AMI patients after PCI(P<0.05).Conclusion The detection of serum Gal-3 and CysC levels before emergency PCI surgery has high predictive value for the occurrence of postoperative AKI in AMI patients,with high sensitivity and specificity.
作者
牛少辉
蒋友旭
熊海燕
栗媛
张丽华
NIU Shaohui;JIANG Youxu;XIONG Haiyan;LI Yuan;ZHANG Lihua(Department of Cardiovascular Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2024年第21期3896-3899,共4页
Henan Medical Research
基金
河南省医学科技攻关计划项目(LHGJ20200397)
郑州市医疗卫生领域科技创新指导计划项目(2024YLZDJH089)。
关键词
急性心肌梗死
冠状动脉介入术
急性肾损伤
半乳糖集素-3
胱抑素C
acute myocardial infarction
percutaneous coronary intervention
acute kidney injury
galactose lectin-3
cystatin C
