术前基础血清胱抑素C水平与对比剂诱导的急性肾损害的相关性研究  

Association between basal cystatin C and contrast-induced acute kidney injury

作　　者：梁登攀[1] 周鹏[1] 王秋林[1] 蔡国才[1] 李璐[1] 蒋利成[1] 李文章[1] 杨震[1] 蒲静[1] 

机构地区：[1]成都医学院第一附属医院心血管内科,成都610500

出　　处：《中国循证心血管医学杂志》2016年第12期1445-1448,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：成都医学院课题项目(CYZ11-020)

摘　　要：目的探讨疑诊冠心病患者经冠状动脉造影和（或）冠状动脉介入治疗术前基础血清胱抑素C水平与对比剂诱导的急性肾损害（CI-AKI）的关系。方法连续入选2012年1月-2014年1月在成都医学院第一附属医院行冠状动脉造影和（或）冠状动脉介入治疗的疑诊冠心病患者1152例,对其资料进行回顾性分析。按基础血清胱抑素C水平的三分位数进行分组：T1组≤0.95 mg/L,共362例;T2组0.95-1.08mg/L,共363例;T3组≥1.08 mg/L,共427例。通过多因素Logistic回归分析冠状动脉造影和（或）冠状动脉介入治疗术后发生CI-AKI的危险因素。结果 T1组共362例,平均年龄（61.9±7.2）岁,男性137例（37.8%）;T2组共363例,平均年龄（62.3±7.3）岁,男性152例（41.9%）;T3组共427例,平均年龄（63.1±7.2）岁,男性190例（44.5%）。纳入研究人群中发生CI-AKI的患者共73例（6.3%）,CIAKI患者的基础血清胱抑素C水平为（1.24±0.29）mg/L,显著高于非CI-AKI患者的（1.06±0.37）mg/L（P〈0.001）。T3组共48例（11.2%）发生CI-AKI,显著高于T1组7例（1.9%）、T2组8例（5.0%）（P〈0.001）。多因素Logistic回归分析显示,校正年龄、性别、糖尿病、肌酐、尿酸、对比剂用量等因素后,与T1组相比,T2组术后发生CI-AKI的风险未见明显升高（P=0.178）,T3组术后发生CI-AKI的风险增加2.89倍（P=0.017）。结论冠状动脉造影和（或）冠状动脉介入治疗术前较高的基础血清胱抑素C水平可增加CI-AKI的风险。Objective To investigate the relationship between basal serum cystatin C levels and contrastinduced acute renal injury（CI-AKI） in patients with suspected coronary artery disease before undergoing coronary angiography and / or percutaneous coronary intervention. Methods A total of 1152 patients undergoing coronary angiography and / or percutaneous coronary intervention were enrolled, and divided into three groups according to the tertile of basal serum cystatin C levels（group T1： ≤0.95mg/L, n=362; group T2： 0.95-1.08mg/L, n=363; group T3：≥1.08mg/L, n=427）. Multivariate logistic regression analysis was used to analyze the independent risk factors for CI-AKI. Results There were 362 patients in group T1 including 137 males（37.8%） with mean age（61.9±7.2）, 363 patients group T2 including 152 males（41.9%） with mean age（62.3±7.3）, and 427 patients in group T3 including 190 males（44.5%） with mean age（63.1±7.2）. Among all of the study patients, 73 cases（6.3%） developed CI-AKI. Baseline cystatin C was higher in CI-AKI patients than in Non-CI-AKI patients [（1.24±0.29） mg/L vs.（1.06±0.37） mg/L, P〈0.001]. After adjustment for age, gender, creatinine, uric acid, diabetes mellitus, contrast medium volume, risk of CI-AKI was significantly higher in group T3 than in group T1（OR： 2.890, 95%CI： 1.205-6.929, P=0.017）. Conclusion Elevated basal serum cystatin C levels may increase the risk of CI-AKI before coronary angiography and / or percutaneous coronary intervention.

关 键 词：对比剂诱导的急性肾损害 胱抑素C 肾功能不全 

分 类 号：R692[医药卫生—泌尿科学]