冠状动脉造影或经皮冠状动脉介入术前患者临床列线图预测术后发生对比剂急性肾损伤的风险  

Development of preprocedure nomogram for predicting contrast-induced acute kidney injury after coronary angiography or percutaneous coronary intervention

作　　者：欧阳富盛 郭保亮[1,2,3] 张斌 张璐[1,2] 张水兴[1,2] 

机构地区：[1]南方医科大学研究生院,广东广州510515 [2]广东省医学科学院广东省人民医院放射科,广东广州510080 [3]南方医科大学顺德医院放射科,广东佛山528300 [4]暨南大学第一附属医院医学影像中心,广东广州510630

出　　处：《中国介入影像与治疗学》2017年第12期724-728,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金面上项目(81571664;81171329);广东省科技计划项目(2016A020216020;2014A020212244);佛山市医学类科学攻关项目(2017AB003623;2017AB003683)

摘　　要：目的构建接受冠状动脉造影(CAG)或经皮冠状动脉介入(PCI)治疗患者术前临床指标的列线图,据此预测术后发生对比剂急性肾损伤(CI-AKI)的风险。方法收集245例接受CAG或PCI治疗患者的术前临床资料。采用LASSO回归方法筛选与CI-AKI相关的临床特征,据以构建列线图预测模型,计算CI-AKI风险分数。绘制ROC曲线,计算风险评分临界值。结果 245例中,34例(34/245,13.88%)发生CI-AKI。LASSO回归分析显示性别、糖尿病史、乳酸脱氢酶水平、超敏C反应蛋白,饮酒年限、慢性肾脏病及其分期、脑卒中史、急性心肌梗死及收缩压是CI-AKI风险评分和预测模型的危险因素。CI-AKI列线图预测效能较好,其风险评分临界值为-1.953。结论列线图可用于术前预测患者接受CAG或PCI治疗后发生CI-AKI的风险。Objective To establish a preprocedure nomogram for predicting contrast-induced acute kidney injury （CI-AKI） after coronary angiography （CAG） or percutaneous coronary intervention （PCI）. Methods Clinical data of 245 patients underwent CAG or PCI were collected. CI-AKI prediction nomogram integrated preprocedural predictors was established with clinical characteristics associated with CI-AKI which were selected with the LASSO regression model, and CI-AKI risk scores were calculated. The ROC curve was constructed to calculate the risk score cutoff. Results The occurrency of CI-AKI was 13.88% （34/245）. Sex, diabetes mellitus, lactate dehydrogenase level, high-sensitivity C-reactive protein, drinking years, chronic kidney disease （CKD）, stage of CKD, stroke, acute myocardial infarction as well as systolic blood pressure were significant risk factors. The efficiency of CI-AKI nomogram was good, and the cutoff value of risk score was -1.953. Conclusion The novel nomogram can be used to preprocedurally predict the risk of CI-AKI after CAG or PCI treatment.

关 键 词：对比剂急性肾损伤 列线图 冠状血管造影术 经皮冠状动脉介入治疗 

分 类 号：R692[医药卫生—泌尿科学] R815[医药卫生—外科学]