CHADACv评分与肾损伤分子-1检测对行经皮冠状动脉介入治疗冠心病患者造影剂肾病的评估价值  

CHADACv score and urine renal injury molecular-1 predicting risk of contrast induced nephropathy in coronary artery disease patients undergoing percutaneous coronary

作　　者：李永旺[1] 杨同肖 侯丽萍[1] 钟雪焱[1] 谭红[1] 徐慧[1] 王力[1] LI Yong-wang;YANG Tong-xiao;HOU Li-ping;ZHONG Xue-yan;TAN Hong;XU Hui;WANG Li(Department of Cardiology,Dalian Friendship Hospital y Dalian 116001,China;Graduate School of Jinzhou Medical Uniwersity,Jinzhou 121001,China)

机构地区：[1]大连市友谊医院心内科,辽宁省大连市116001 [2]锦州医科大学研究生学院

出　　处：《中国心血管病研究》2019年第11期994-998,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的通过CHADACv评分和肾损伤分子-1(kidney injury molecule-1,KIM-1)检测,对应用造影剂的冠心病患者进行评价,探讨CHADACv评分和KIM-1对造影剂肾病的预测价值.方法选取拟行PCI冠心病患者200例,均行CHADACv评分,根据CHADACv评分0分、1~3分和>3分分为三组.查左心室射血分数(LVEF),术前1天和术后48 h KIM-1、血清胱抑素C(CysC)、血清肌酐(Scr)检测.结果与CHADACv评分为0分和1~3分组相比,CHADACv评分>3分组KIM-1水平显著升高[(1563±463)pg/mg.Cr比(386±164)pg/mg.Cr,P<0.01;(1563±463)pg/mg·Cr比(862±378)pg/mg·Cr,P<0.05],而CysC随CHADACv评分增高有增高趋势,但无显著差异.研究发现CHADACv评分与KIM-1水平呈正相关(r=0.46,P<0.05),血清肌酐水平与CHADACv评分显著相关(r=0.42,P<0.05),血清CysC水平与CHADACv评分无显著相关性(r=0.16,P>0.05).结论CHADACv评分与KIM-1检测能够反映冠心病患者应用造影剂后造影剂肾病的发生,且造影剂肾病与CHADACv评分和KIM-1水平呈正相关.Objective:To evaluate the pridictive value of CHADACV score and kim-1 in patients with coronary artery disease using contrast agents,and to explore the risk of contrast induced nephropathy used CHADACV score and kim-1.Methods:200 patients with coronary heart disease who planned to undergo PCI were selected and all received CHADACV score.According to the CHADACV score of 0,1-3 and>3,they were divided into three groups.Left ventricular ejection fraction(EF),KIM-1,serum cystatin C(Cys-C),serum creatinine(Scr)were detected 1 day before and 48 hours after surgery.Results:compared with the CHADACV score of 0 and the 1-3 group,the level of KIM-1 in the CHADACV score>3 group was significantly increased(P<0.05),while the level of Cys-c increased with the CHADACV score,but there was no significant difference.In addition,it was found that CHADACV score was positively correlated with KIM-1 level(r=0.46,P<0.05),serum creatinine level was significantly correlated with CHADACV score(r=0.42,P<0.05),and serum Cys-C level was not significantly correlated with CHADACV score(r=0.16,P>0.05).Conclusion:CHADACV score and kim-1 test can reflect contrast induced nephropathy in patients with coronary heart disease after the application of contrast agent,and contrast induced nephropathy is positively correlated with CHADACV score and KIM-1 level.

关 键 词：CHADACv评分 造影剂肾病 肾损伤分子-1 

分 类 号：R541.4[医药卫生—心血管疾病]