铁调素对急性冠状动脉综合征患者PCI术后造影剂急性肾损伤的预测价值  

Value of hepcidin in predicting the occurrence of contrast-induced acute kidney injury after PCI in patients with acute coronary syndrome

作　　者：严语[1] 毛霄鹏[2] YAN Yu;MAO Xiaopeng(Department of Cardiology,Jiangbei Hospital Area of Zhongda Hospital,Southeast University,Nanjing 210009,CHINA)

机构地区：[1]东南大学附属中大医院江北院区心内科,江苏南京210009 [2]东南大学附属中大医院全科医学科

出　　处：《江苏医药》2021年第3期299-303,共5页Jiangsu Medical Journal

摘　　要：目的探讨铁调素对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后发生造影剂急性肾损伤(CI-AKI)的预测价值。方法检测480例ACS患者的血清铁调素、术前及术后2~3 d的血肌酐水平及其他生化指标,记录冠状动脉病变程度和心脏彩超结果。根据术前血清铁调素水平将患者分为组1(铁调素≤36.49μg/L,120例)、组2(36.50μg/L≤铁调素≤89.15μg/L,120例)、组3(89.16μg/L≤铁调素≤173.88μg/L,120例)和组4(铁调素≥173.89μg/L,120例)。分析铁调素对ACS患者PCI术后发生CI-AKI的预测价值。结果术后CI-AKI发生情况:组1发生10例(8.3%),组2发生19例(15.8%),组3发生24例(20.0%),组4发生29例(24.2%);四组患者PCI术后CI-AKI发生率随铁调素水平的增高而增加(P<0.05)。多因素logistic回归分析显示,在校正其他因素后,较高水平的铁调素、高龄、贫血和糖尿病是ACS患者PCI术后发生CI-AKI的独立预测因子(P<0.05)。铁调素预测ACS患者PCI术后CI-AKI的AUC为0.786[95%CI(0.727~0.844),P<0.05]。结论铁调素水平能有效预示ACS患者PCI术后发生CI-AKI。高龄、贫血和糖尿病是ACS患者PCI术后发生CI-AKI的危险因素。Objective To explore the value of hepcidin in predicting the occurrence of contrast-induced acute kidney injury(CI-AKI) after percutaneous coronary intervention(PCI) in the patients with acute coronary syndrome(ACS).Methods PCI was performed in 480 patients with ACS,in whom serum hepcidin, creatinine concentration(SCr) before and 2 to 3 days after contrast media exposure and other biochemical indicators were detected.According to hepcidin level, the patients were equally assigned into four groups of A(hepcidin≤36.49 μg/L),B(36.50 μg/L≤hepcidin≤89.15 μg/L),C(89.16 μg/L ≤ hepcidin ≤ 173.88 μg/L),and D(hepcidin ≥ 173.89 μg/L).The value of hepcidin in predicting the occurrence of CI-AKI after PCI was analyzed.Results The incidence rates of CI-AKI in ACS patients after PCI were 8.3% in group A(10 cases),15.8% in group B(19 cases),20.0% in group C(24 cases) and 24.2% in group D(29 cases),respectively.The incidence was increased with the increase of hepcidin level(P<0.05).Multiple logistic regression analysis showed that hepcidin, age, anemia, and diabetes were the independent predictors for CI-AKI in ACS patients after PCI(P<0.05).The AUC of hepcidin predicting the incidence of CI-AKI in ACS patients after PCI was 0.786 [95%CI(0.727-0.844),P<0.05].Conclusion Serum hepcidin level is an early biomarker in predicting CI-AKI in ACS patients after PCI.Age, anemia, and diabetes are the risk factors for CI-AKI after PCI in ACS patients.

关 键 词：铁调素 造影剂急性肾损伤 急性冠状动脉综合征 经皮冠状动脉介入 

分 类 号：R541[医药卫生—心血管疾病]