miRNA -21在冠脉介入术后对比剂肾病的早期诊断价值  

Early Diagnostic Value of miRNA - 21 in Contrast Induced Nephropathy after Percutaneous Coronary Intervention

作　　者：乔平[1] 吴明[1] 马建林[1] 林劲[1] 马立宁[1] 

机构地区：[1]海南省人民医院心内科,海南海口570311

出　　处：《医学新知》2016年第4期255-258,共4页New Medicine

基　　金：海南省自然科学基金面上项目（项目号20168288）

摘　　要：目的：评价 miNRA -21在冠脉介入术后对比剂肾病（Contrast induced Nephropathy CIN）早期诊断的价值。方法连续选择2014年3月~2015年8月在我院心血管内科择期行冠状动脉介入诊疗的患者253例，对所有受试者术前测量其血压，测血糖、血脂、基础尿素氮、肌酐值、C 反应蛋白，并计算肾小球滤过率；提取外周血总 miRNA，应用荧光实时定量 PCR（qRT - PCR）方法检测其术前及术后4h miRNA -21含量。分别于介入术后24 h、48 h、72 h 测患者血肌酐值。根据 CIN 发生与否分为 A 组（CIN 组）33例、B 组（非 CIN 组）220例，同时记录患者在术中对比剂的用量。结果253例患者中33例发生 CIN，发生率为13.04%，A 组患者的基础尿素氮、肌酐、纤维蛋白原、C 反应蛋白及 miRNA -21的表达等均高于 B 组，肾小球滤过率则低于 B组。术后 miNRA -21水平 CIN 组明显升高，差异有统计学意义。Logisitic 多因素回归分析显示，肾小球滤过率及肌酐、miNRA -21是 CIN 发生的独立危险因素。ROC 曲线分析提示，术后4 h miRNA -21为1.38时，诊断 CIN 敏感性为91.7%，特异性为80.3%，可较好预测 CIN 的发生。结论术后 miNRA -21是 CIN 发生的独立危险因素，对于预测 CIN 的发生，提前预防 CIN 有重要的意义。Objective To evaluate early diagnostic value of miRNA - 21 in contrast induced nephropathy（CIN） after percutaneous coronary intervention（PCI）. Methods A total of 253 patients who underwent PCI were selected from Mar. 2014 to Aug. 2015. Blood pressure,blood glucose,blood lipid,urea nitrogen,creatinine levels and C - re-active protein were measured and glomerular filtration rate was caculated before operation. Total miRNA in peripheral blood was extracted. Plasma miRNA - 21 was measured by qRT - PCR before operation and 4 hours after operation. Serum creatinine levels were measured 24 h,48 h and 72 h after operation,respectively. All patients were divided into group A（CIN group,n = 33）and group B（NO CIN group,n = 220）. Results 13. 04% of patients developed CIN（group A）. The expressions of urea nitrogen,creatinine levels,fibrinogen,C - reactive protein and miRNA - 21 in group A were significantly higher than those in group B. Glomerular filtration rate in group A was lower than that in group B. miRNA - 21 level in CIN group after operation increased significantly. Logistic regression analysis indicated that glomerular filtration rate,level of creatinine and miRNA - 21 were independent risk factors of CIN occurrence. ROC curve indicated that 4 h miRNA - 21 after operation was 1. 38,diagnostic sensitivity of CIN was 91. 7% and specificity was 80. 3% ,which could predict the occurrence of CIN preferably. Conclusion miRNA - 21 after opera-tion is an independent risk factor of the occurrence of CIN,which is of great significance in predicting the occurrence of CIN and preventing CIN.

关 键 词：MIRNA-21 对比剂肾病 冠状动脉介入治疗 早期诊断 

分 类 号：R692.5[医药卫生—泌尿科学]