尿钠/尿钾对冠心病患者PCI术后造影剂诱导急性肾损伤发生的诊断价值  

Diagnostic value of urinary sodium/potassium ratio in contrast-induced acute kidney injury in patients with coronary heart disease after PCI

作　　者：张爱民[1] 李素华[1] 叶海峰[1] 贺宝臣 杨志家[2] ZHANG Aimin;LI Suhua;YE Haifeng;He Baochen;YANG Zhijia(Department of Cardiac Surgery,Handan Central Hospital,Handan,Hebei 056000,China;Department of Cardiology,Handan Central Hospital,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市中心医院心外科,河北邯郸056000 [2]河北省邯郸市中心医院心内三科,河北邯郸056000

出　　处：《国际检验医学杂志》2021年第16期1961-1965,共5页International Journal of Laboratory Medicine

基　　金：2020年度河北省医学科学研究课题计划(20200489)。

摘　　要：目的探讨尿钠/尿钾对冠心病患者经皮冠状动脉介入治疗(PCI)术后造影剂诱导急性肾损伤(CI-AKI)发生的诊断价值。方法选取该院2017年11月至2020年9月收治的行PCI术的冠心病患者368例作为研究对象,根据PCI术后接触造影剂(碘对比剂)3 d内肌酐水平分为CI-AKI组(76例)和非CI-AKI组(292例)。采用全自动生化分析仪检测所有患者尿液中尿钠、尿钾水平,计算尿钠/尿钾。采用受试者工作特性曲线(ROC曲线)分析尿钠/尿钾对冠心病患者PCI术后CI-AKI的诊断价值;采用Logistic分析影响冠心病患者PCI术后CI-AKI的因素。结果与CI-AKI组比较,非CI-AKI组男性比例、左室射血分数(LVEF)水平均升高,体质量指数、糖尿病史比例、白细胞计数、空腹血糖、超敏C反应蛋白(hs-CRP)、肾小球滤过率(eGFR)、尿钠、尿钠/尿钾水平均降低,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,尿钠/尿钾预测冠心病患者PCI术后CI-AKI的ROC曲线下面积为0.773,截断值为5.56,其灵敏度为71.10%,特异度为74.30%。Logistic回归分析结果显示,hs-CRP、eGFR、尿钠、尿钠/尿钾是影响冠心病患者PCI术后发生CI-AKI的危险因素(P<0.05),LVEF是影响冠心病患者PCI术后发生CI-AKI的保护因素(P<0.05)。结论尿钠/尿钾对冠心病患者PCI术后CI-AKI的发生具有一定的诊断价值,是冠心病患者PCI术后发生CI-AKI的危险因素,在临床上具有一定价值。Objective To investigate the diagnostic value of urinary sodium/potassium ratio on contrast-induced acute kidney injury(CI-AKI)in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods From November 2017 to September 2020,a total of 368 patients with coronary heart disease undergoing PCI in the hospital were selected and divided into CI-AKI group(76 cases)and non CI-AKI group(292 cases)according to the level of creatinine within 3 days after PCI exposure to contrast medium(iodine contrast medium).Urine sodium and potassium levels in all patients were detected by automatic biochemical analyzer,and the ratio of urinary sodium to potassium was calculated.Receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic value of urinary sodium/potassium ratio for CI-AKI in patients with coronary heart disease after PCI.Logistic analysis was used to analyze the factors influencing CI-AKI in patients with coronary heart disease after PCI.Results Compared with CI-AKI group,the male proportion and left ventricular ejection fractions(LVEF)level in non CI-AKI group were higher,body mass index,diabetes history ratio,white blood cell count,fasting blood glucose,hypersensitive C reactive protein(hs-CRP),glomerular filtration rate(eGFR)level,urinary sodium and urinary sodium/potassium ratio were lower in non CI-AKI group compared with CI-AKI group,and the differences were statistically significant(P<0.05).ROC curve showed that the area under ROC curve of urinary sodium/potassium ratio for predicting CI-AKI in patients with coronary heart disease after PCI was 0.773,the cut-off value was 5.56,the sensitivity was 71.10%,and the specificity was 74.30%.Logistic regression analysis showed that hs-CRP,eGFR,urinary sodium and urinary sodium/potassium ratio were risk factors for CI-AKI in patients with coronary heart disease after PCI(P<0.05),while LVEF was a protective factor for CI-AKI in patients with coronary heart disease after PCI(P<0.05).Conclusion Urinary sodium/potassium

关 键 词：尿钠/尿钾 冠心病 经皮冠状动脉介入治疗 造影剂诱导急性肾损伤 诊断价值 

分 类 号：R694.5[医药卫生—泌尿科学]