miRNA-21/肾小球滤过率与冠脉介入术后对比剂肾病发生的相关性  

Association of miRNA-21 to estimated glomerular filtration rate ratio with development of contrast induced nephropathy after percutaneous coronary intervention

作　　者：乔平[1] 吴明[1] 林劲[1] 马立宁[1] QIAO Ping;WU Ming;LIN Jing;MA Liling(Department of Cardiology,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院心内科,海口570311

出　　处：《实用医学杂志》2018年第19期3238-3241,共4页The Journal of Practical Medicine

基　　金：海南省自然科学基金面上项目(编号:20168288)

摘　　要：目的研究miRNA-21/肾小球滤过率与冠脉介入术后对比剂肾病(CIN)发生的相关性,以期早期诊断CIN的发生。方法选择2016年1月至2017年1月心血管内科择期行冠状动脉介入诊疗的患者168例,对所有受试者检测其生化指标并计算肾小球滤过率、运用荧光实时定量PCR(qRT-PCR)方法检测miRNA-21含量。根据CIN发生与否分为A组(CIN组)和B组(非CIN组)。同时记录患者在术中对比剂的用量。结果有23例发生CIN,发生率为13.6%,A组患者的基础尿素氮、肌酐、C反应蛋白、纤维蛋白原及miRNA-21的表达、miRNA-21/肾小球滤过率的比值等均高于B组,肾小球滤过率则低于B组。BinaryLogisitic回归分析显示,肾小球滤过率及肌酐、miRNA-21、miRNA-21/肾小球滤过率是CIN发生的独立危险因素。ROC曲线分析提示,miRNA-21/肾小球滤过率的比值为6.89时,诊断CIN敏感性为91.6%,特异性为73.8%,可较好的预测CIN的发生。结论 miRNA-21/肾小球滤过率的比值是CIN的发生的独立危险因素,术前计算miRNA-21/肾小球滤过率对于预测CIN的发生,提前预防CIN有重要的意义。Objective To investigate the association of miRNA-21 to estimated glomerular filtration rate(miRNA-21/GFR)ratio with development of contrast induced nephropathy(CIN)afte percutaneous coronary inter-vention(PCI).Methods From January 2016 to January 2017,a total of 168 patients who underwent PCI were selected.Anthropometric measures,fasting blood,lipid profiles,CRP,base creatinine,miRNA-21 were mea-sured before the procedure.Glomerular filtration rate was calculated by MDRD formula.Contrast volume(CV)was recorded after the procedure.Serum creatinine was measured at hours 24,48,and 72,respectively.CIN was defined as an increase in serum creatinine levels of 25%or 44umol/L or more from baseline within 72 h after PCI.All the patients were divided into group A(CIN group)and group B(NO CIN group).Results 13.6%of the patients developed CIN(group A).The others did not occur CIN(no CIN group).Levels of base creatinine,CRP,miRNA-21 and miRNA-21/GFR were significantly higher in group A than in group B(P<0.01).GFR in group A was lower than that in group B(P<0.05).Binary Logistic regression analysis indicated that levels of base creatinine,GFR,miRNA-21 and miRNA-21/GFR were independent risk factors of CIN occurrence(P<0.05).The receiver-operator characteristic curve analysis indicated that a miRNA-21/GFR ratio of 6.89 was a fair discrim-inator for CIN;the sensitivity was 91.6%,and the specificity was 73.8%.Conclusion A miRNA-21/GFR ratio was an independent predictor of CIN after PCI.

关 键 词：MIRNA-21 肾小球滤过率 对比剂肾病 冠状动脉介入治疗 

分 类 号：R692[医药卫生—泌尿科学]