外周血同型半胱氨酸浓度与急性心肌梗死患者经皮冠状动脉介入治疗后发生造影剂相关肾病的相关性  

Correlation analysis of concentration of homocysteinemia in peripheral blood and contrast-induced nephropathy after percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：曾波[1] ZENG Bo(Department of Cardiology,The First People′s Hospital of Nanning City,Nanning 530022,China)

机构地区：[1]南宁市第一人民医院心血管内科,南宁530022

出　　处：《岭南心血管病杂志》2017年第6期677-680,684,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨外周血同型半胱氨酸(homocysteinemia,Hcy)浓度与急性心肌梗死患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后发生造影剂相关肾病的相关性。方法选取2014年1月至2015年12月在南宁市第一人民医院经PCI治疗的急性心肌梗死患者1026例,检测患者PCI治疗前及治疗后2~3 d内的血清肌酐(serum creatinine,sCr)浓度。根据是否患有造影剂肾病(contrast-induced nephropathy,CIN),将患者分为CIN组(198例)和非CIN组(828例),比较两组基线、急性心肌梗死及PCI治疗的特征数据,并采用Logistic回归分析及受试者工作特征(receiver operator characteristic,ROC)曲线分析各因素与CIN的相关性。结果 1026例患者中CIN的发生率为19.30%(198例)。Logistic回归分析得出,血浆Hcy浓度与CIN的发生有显著相关性(OR=1.55,95%CI:1.39~1.65,P=0.001)。ROC曲线结果显示:当Hcy≥16μmol/L时,判断CIN的灵敏度为0.632,特异性为0.732,曲线下面积为0.739,95%CI为0.709~0.769。结论高浓度的外周血Hcy可预测PCI治疗后CIN的发生。Objectives To investigate the correlation between peripheral blood concentration of homocysteinemia(Hcy)and contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Totally1026cases from January2014to December2015in The First People′s Hospital of Nanning City suffering from AMI and undergoing PCI were enrolled.Serum concentration of creatinine(sCr)was measured before and two to three days after PCI in the patients.According to whether suffering from CIN,patients were divided into two groups:CIN groups(198cases)and non CIN groups(828cases).Baseline clinical data,AMI and PCI characteristic data between the two groups were compared.Logistic regression and receiver operator characteristic(ROC)curve were used to assess the correlations between clinical factors and CIN.Results Incidence of CIN was19.30%(198cases)in the1026patients.Logistic regression analysis showed that peripheral blood concen?tration of Hcy and incidence of CIN had significant correlation(OR=1.55,95%CI:1.39-1.65,P=0.001).ROC curve results showed that as Hcy≥16μmol/L,the judging sensitivity of CIN was0.632,the specificity was0.732,the area under the curve was0.739,95%CI was0.709-0.769.Conclusions High peripheral blood concentration of Hcy can predict the occurrence of CIN after PCI.

关 键 词：心肌梗死 同型半胱氨酸 血管成形术 经腔 经皮冠状动脉 造影剂肾病 

分 类 号：R542.22[医药卫生—心血管疾病]