三种FAS公式估算的肾小球滤过率对冠心病监护室患者全因死亡的预测价值  

Predictive value of glomerular filtration rate estimated by three FAS formulas for all-cause mortality in patients in coronary care unit

作　　者：杨敏[1] 徐丝 吴莎[1] 李晓宁[1] Yang Min;Xu Si;Wu Sha;Li Xiao-ning(Department of Nephrology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院肾内科,430071

出　　处：《临床肾脏病杂志》2021年第7期535-539,共5页Journal Of Clinical Nephrology

摘　　要：目的比较三种FAS公式估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)对冠心病监护室(Coronary Care Unit,CCU)患者全因死亡的预测价值。方法回顾性分析2014年1月1日至2015年6月1日武汉大学中南医院CCU收治的369例患者的临床资料,使用三种FAS公式分别计算eGFR(eGFR FAS Scr,eGFR FAS CysC,eGFR FAS Scr-CysC),采用Cox回归分析CCU患者全因死亡的影响因素,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),评估影响因素对CCU患者全因死亡的预测价值。结果369例CCU患者中,93例发生全因死亡事件(25.2%)。单因素COX回归分析显示,年龄、发生急性肾损伤(acute kidney injury,AKI)、手术、使用血管活性药物、使用呼吸机、血红蛋白、白蛋白、血清胱抑素C(cystatin C,CysC)、血肌酐(serum creatinine,Scr)、超敏C反应蛋白、急性生理与慢性健康状况(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、慢性肾脏病病史、eGFR FAS Scr、eGFR FAS CysC、eGFR FAS Scr-CysC与CCU患者全因死亡相关(均P<0.05);多因素COX回归分析显示,eGFR FAS CysC(HR=0.960,95%CI:0.928~0.992,P=0.016)是患者全因死亡的独立影响因素。eGFR FAS CysC预测CCU患者全因死亡的ROC曲线下面积较大(AUC:0.842,P<0.001)。结论eGFR FAS CysC是CCU患者全因死亡的独立预测因子。Objective To compare the predictive value of estimated glomerular filtration rate(eGFR)estimated by three FAS formulas for all-cause mortality in coronary care unit(CCU)patients.Methods From January 1,2014 to June 1,2015,a total of 369 CCU patients were recruited.The values of eGFR FASScr,eGFR FASCysC and eGFR FASScr-CysC were calculated by three FAS formulas.Cox regression analysis was utilized for examining the influencing factors of all-cause mortality and receiver operating characteristic curve(ROC)was plotted for evaluating the predictive value of the influencing factor for all-cause mortality in CCU patients.Results Among them,93(25.2%)had all-cause mortality events.Univariate Cox regression analysis revealed that age,AKI,operation,use of vasoactive drugs,use of breathing machine,hemoglobin(Hb),albumin(Alb),cystatin C(CysC),serum creatinine(Scr),high sensitivity-C reactive protein(hs-CRP),acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,chronic kidney disease history,eGFR FASScr,eGFR FASCysC and eGFR FASScr-CysC were associated with all-cause mortality(P<0.05).And multivariate Cox regression analysis showed that eGFR FASCysC(HR=0.960,95%CI:0.928~0.992,P=0.016)was an independent influencing factor for all-cause mortality in CCU patients.And eGFR FASCysC might predict a larger area under the ROC curve for all-cause mortality in CCU patients.Conclusion eGFR FASCysC is an independent predictor of all-cause mortality in CCU patients.

关 键 词：肾小球滤过率 冠心病重症监护病房 全因死亡 

分 类 号：R541.4[医药卫生—心血管疾病]