摘要
目的探讨冠心病患者行冠脉造影和(或)介入治疗术前胱抑素C水平对对比剂肾病(CIN)的预测价值。方法选取行冠状动脉造影或介入治疗患者500例,计算CIN的发生率。按照术后肌酐增高的程度分为非CIN组(肌酐增高0～44.2μmol/L),CIN组(肌酐增高>44.2μmol/L)。测定2组患者术前胱抑素C水平,比较2组间胱抑素C改变,了解使用对比剂患者胱抑素C水平有无变化。采用ROC曲线,判断胱抑素C水平在CIN中的预测价值。结果 500例患者CIN的发生率为5.6%。CIN组术前胱抑素C水平为(1.286±0.27)mg/L,非CIN组术前胱抑素C水平为(0.99±0.18)mg/L,CIN组术前胱抑素C水平显著升高(P<0.05)。Pearson相关分析显示,血清胱抑素C水平与术前血清肌酐呈正相关性(r=0.56,P<0.05),与GFR呈负相关性(r=-0.59,P<0.05)。ROC曲线下面积分别为0.803(95%可信区间为0.671～0.934)和0.763(95%可信区间为0.636～0.889),最佳临界点值分别为0.995 mg/L和74.55μmol/L。结论冠脉介入诊疗患者术前检测胱抑素C水平较肌酐能更好地预测CIN的发生,术前胱抑素C水平与CIN的发生有密切关系。
Objective To investigate the predictive value of cystatin C level before coronary angiography and/or interventional therapy for contrast-induced nephropathy(CIN).Methods 500 patients undergoing coronary angiography or interventional therapy were selected and the incidence of CIN was calculated.According to the degree of creatinine increase after operation,the patients were divided into non-CIN group(creatinine increase 0~44.2μmol/L)and CIN group(creatinine increase greater than 44.2μmol/L).The levels of cystatin C were measured before operation and the changes of cystatin C(Cys C)were compared between the two groups to find out whether the levels of cystatin C were changed in patients using contrast agents.The ROC curve was used to determine the predictive value of cystatin C level in CIN.Results The incidence of CIN was 5.6%.The preoperative Cys C level in CIN group was(1.286±0.27)mg/L,while that in non-CIN group was(0.99±0.18)mg/L.The preoperative Cys C level in CIN group was significantly higher than that in CIN group(P<0.05).Pearson correlation analysis showed that serum Cys C level was positively correlated with preoperative serum creatinine(r=0.56,P<0.05)and negatively correlated with GFR(r=-0.59,P<0.05).The area under ROC curve was 0.803(95%confidence interval was 0.671~0.934)and 0.763(95%confidence interval was 0.636~0.889),respectively.The optimum critical points were 0.995 mg/L and 74.55μmol/L,respectively.Conclusion Preoperative detection of cystatin C level in patients undergoing coronary intervention is better than preoperative creatinine in predicting the occurrence of CIN.Preoperative cystatin C level is closely related to the occurrence of CIN.
作者
李海
康雅贤
徐清斌
李奔
LI Hai;KANG Yaxian;XU Qingbin;LI Ben(The Cardio-Cerebral Vascular Disease Hospital of General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《宁夏医学杂志》
CAS
2019年第4期317-319,288,共4页
Ningxia Medical Journal
关键词
冠脉介入诊疗
胱抑素C
对比剂肾病
Coronary intervention
Cystatin C
Contrast-induced nephropathy
