尿可溶性髓样细胞触发受体-1对老年经皮冠状动脉介入术后患者造影剂肾病的预测价值  

Predictive value of urinary triggering receptors expressed on myeloid cells-1 on contrast-induced ne⁃phropathy after percutaneous coronary intervention

作　　者：赖冬艳 韦颖[1] 莫昌干[1] 贝晓娜 韦光所 孙伟东 韦刚 梁承院 Lai Dong-yan;Wei Yin;Mo Chang-gan;Bei Xiao-na;Wei Guang-suo;Sun Wei-dong;Wei Gang;Liang Cheng-yuan(Department of Cardiology,Hechi People's Hospital,Hechi 547000,China)

机构地区：[1]河池市人民医院心血管内科,河池547000

出　　处：《临床肾脏病杂志》2022年第4期310-314,共5页Journal Of Clinical Nephrology

基　　金：河池市科学研究与技术开发计划(河科攻1623-15)。

摘　　要：目的探讨尿可溶性髓样细胞触发受体-1(triggering receptors expressed on myeloid cells-1,sTREM-1)对老年经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后患者造影剂肾病(contrast-induced nephropathy,CIN)的早期诊断意义。方法选取行PCI术患者,按是否发生CIN分为CIN组(n=21)和非CIN组(n=179)。对比两组患者血肌酐、估算肾小球滤过率(estimated glo⁃merular filtration rate,eGFR)、尿sTREM-1差异,分析尿sTREM-1与血肌酐及eGFR的相关性,以及尿sTREM-1对CIN的早期诊断价值。结果CIN组患者年龄[(71.48±8.51)岁比(62.92±9.16)岁]及2型糖尿病患病率(57.15%比34.64%)明显高于非CIN组(P<0.05)。术后4 h、24 h、48 h,CIN组患者尿sTREM-1含量[(111.02±14.73)ng/L比(47.45±10.36)ng/L、(123.81±28.51)ng/L比(49.29±12.46)ng/L、(134.69±30.37)ng/L比(45.31±9.48)ng/L]明显高于非CIN组(P<0.05);术后4 h、24 h,两组患者血肌酐及eGFR比较差异无统计学意义(P>0.05),术后48 h,CIN组患者血肌酐[(89.05±21.13)μmol/L比(63.42±12.42)μmol/L]明显高于非CIN组(P<0.05),eGFR[(76.28±21.89)mL·min^(-1)·(1.73m^(2))^(-1)比(112.94±30.46)mL·min^(-1)·(1.73m^(2))^(-1)]明显低于非CIN组(P<0.05)。尿sTREM-1与血肌酐呈正相关(P<0.05),而尿sTREM-1与eGFR呈负相关(P<0.05)。受试者工作特征(receiver operator characteristic,ROC)曲线分析显示,术后4 h尿sTREM-1的曲线下面积为0.740(95%CI:0.482~0.998),截断点为89.0 ng/L,敏感度和特异度分别为62.6%、73.5%;术后24 h尿sTREM-1的曲线下面积为0.931(95%CI:0.868~0.994),截断点为98.0 ng/L,敏感度和特异度分别为86.6%、73.8%;术后48 h尿sTREM-1的曲线下面积为0.948(95%CI:0.894~1.001),截断点为108.0 ng/L,敏感度和特异度分别为87.9%、88.4%。结论尿sTREM-1可反映PCI术后早期肾功能变化,在CIN早期诊断中具有良好的应用价值。Objective To evaluate the predictive value of urinary soluble triggering receptors ex⁃pressed on myeloid cells-1(sTREM-1)on contrast-induced nephropathy(CIN)after percutaneous coro⁃nary intervention(PCI).Methods Patients undergoing PCI were divided into two groups of CIN(n=21)and non-CIN(n=179)according to the occurrence of CIN.Serum creatinine,estimated glomerular filtration rate(eGFR)and urinary sTREM-1 were compared between two groups.The correlation between urinary sTREM-1,serum creatinine and eGFR were analyzed.And early diagnostic value of urinary sTREM-1 in CIN was examined.Results Age[(71.48±8.51)year vs(62.92±9.16)year]and dia⁃betic rate(57.15%vs 34.64%)of CIN group were significantly higher than those in non-CIN group(P<0.05).At 4 h、24 h、48 h post-operation,urinary sTREM-1[(111.02±14.73)ng/L vs(47.45±10.36)ng/L,(123.81±28.51)ng/L vs(49.29±12.46)ng/L,(134.69±30.37)ng/L vs(45.31±9.48)ng/L]of CIN group was significantly higher than that of non-CIN group(P<0.05).At 4 h、24 h post-operation,serum creatinine and eGFR showed no significant inter-group differences(P>0.05).At 48 h post-operation,serum creatinine[(89.05±21.13)vs(63.42±12.42)μmol/L]of CIN group was sig⁃nificantly higher than that of non-CIN group(P<0.05);eGFR[(76.28±21.89)mL·min^(-1)·(1.73m^(2))^(-1)vs(112.94±30.46)mL·min^(-1)·(1.73m^(2))^(-1)]of CIN group was significantly less than that of non-CIN group(P<0.05).Urinary sTREM-1 was positively correlated with serum creatinine(P<0.05)while urinary sTREM-1 negatively correlated with eGFR(P<0.05).Receiver operator character⁃istic(ROC)analysis showed that AUC of urinary sTREM-1 was 0.740(95%CI:0.482-0.998)at 4 h post-operation;the sensitivity and specificity for diagnosing CIN were 62.6%and 73.5%at a cut-off level of 89.0 ng/L.AUC of urinary sTREM-1 was 0.931(95%CI:0.868-0.994)at 24 h post-operation and the sensitivity and specificity diagnosing CIN were 86.6%and 73.8%at a cut-off level of 98.0 ng/L.AUC of urinary sTREM-1 was 0.948(95%CI:0.894-1.001)at 48 h post-operati

关 键 词：可溶性髓样细胞触发受体1 经皮冠状动脉介入治疗 造影剂肾病 

分 类 号：R541.4[医药卫生—心血管疾病]