胱抑素C在老年患者低剂量造影剂肾病中的预测价值  

Predictive value of cystatin C for low-dose contrast-induced nephropathy in elderly patients

作　　者：黄万众 陈瑜[1] 李维[1] 顾娜[1] 秦艳[1] 陆丽娟[1] HUANG Wan-zhong;CHEN Yu;LI Wei;GU Na;QIN Yan;LU Li-juan(Department of Cardiology,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区江滨医院心内科,南宁市530021

出　　处：《广西医学》2019年第2期157-160,共4页Guangxi Medical Journal

基　　金：广西南宁市青秀区科学研究与技术开发计划(2014S04)

摘　　要：目的探讨胱抑素C(CysC)在老年患者低剂量造影剂肾病(CIN)中的预测价值。方法选取行冠状动脉造影术的老年患者476例,造影剂用量均<100 ml。按照应用造影剂后3 d内CIN发生情况将患者分为CIN组26例及非CIN组450例。于术前以及术后24 h、72 h、7 d,比较两组的CysC、血清肌酐(SCr)水平。采用受试者工作特征曲线评价CysC预测CIN的价值。结果术后各时间点CIN组的SCr及CysC水平均高于非CIN组(均P <0. 05),两组的SCr及CysC水平均有随时间变化的趋势(均P <0. 05)。以术后24 h CysC升高≥25%为截断值诊断CIN曲线下面积最大,为0. 954(P <0. 05),敏感度为92. 3%,特异度为98. 4%,阴性预测值为99. 6%。结论 CysC可以用于预测老年患者低剂量造影剂导致的CIN,以术后24 h CysC水平升高≥25%为截断值的诊断效能最高。Objective To explore the predictive value of cystatin C(CysC)for low-dose contrast-induced nephropathy(CIN)in elderly patients.Methods A total of 476 elderly patients underwent coronary arteriography were enrolled,whose usage dose of contrast medium was less than 100ml.Patients were divided into CIN group(n=26)or non-CIN group(n=450)according to occurrence or not of CIN within 3 days after the application of contrast medium.Before operation,and 24 h,72 h and 7d after operation,CysC and serum creatinine(SCr)levels were compared between the two groups.Predictive value of CysC for CIN was assessed by receiver operative characteristic curve.Results At each time point after operation,SCr and CysC levels were higher in CIN group than in non-CIN group(all P<0.05),and SCr and CysC levels changed with time in both groups(all P<0.05).Area under the curve(0.954)for diagnosing CIN culminated with the increase of CysC≥25%at 24 h after operation as the cutoff(P<0.05),and the sensitivity,specificity and negative predictive value were 92.3%,98.4%and 99.6%respectively.Conclusion CysC can be applied to predict CIN caused by low-dose contrast medium in the elderly patients,and the diagnostic efficacy is the best with the increase of CysC≥25%at 24 h after operation as the cutoff.

关 键 词：造影剂肾病 低剂量 胱抑素C 老年人 

分 类 号：R692[医药卫生—泌尿科学]