小而密低密度脂蛋白及血清胱抑素C对PCI术后对比剂肾病的预测价值  

Predictive Value of Small Dense Low-density Lipoprotein and Serum Cys⁃tatin C for Contrast-induced Nephropathy After Percutaneous Coronary Intervention

作　　者：何海燕 芦菲 顾奕玥 HE Haiyan;LU Fei;GU Yiyue(Department of Cardiology,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou 221000,Ji-angsu,China;Department of Emergency Medicine,the 71 st Group Army Hospital of CPLA Army,Xuzhou 221004,Jiangsu,China)

机构地区：[1]徐州医科大学附属徐州市立医院心血管内科,江苏徐州221000 [2]中国人民解放军陆军第71集团军医院急诊科,江苏徐州221004

出　　处：《系统医学》2024年第19期1-4,22,共5页Systems Medicine

基　　金：徐州市第一人民医院“青苗工程”项目(QMBJ2021007)。

摘　　要：目的 探讨术前小而密低密度脂蛋白(small dense low-density lipoprotein, sd-LDL)与血清胱抑素C(cystatin C, CysC)水平对行经皮冠状动脉介入(percutaneous coronary intervention, PCI)术后对比剂肾病(contrastinduced nephropathy, CIN)发生的预测价值。方法 回顾性选取2022年1月—2023年4月就诊于徐州医科大学附属徐州市立医院200例冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease, CHD)并行PCI治疗符合入选标准患者的临床资料,根据术后血肌酐(serum creatinine, Scr)水平将其分为对比剂肾病组(17例)和非对比剂肾病组(183例)。绘制ROC曲线评价sd-LDL、CysC,以及二者联合对PCI术后CIN的预测价值。结果 术前sd-LDL和血清CysC在CIN组中均高于非CIN组,差异有统计学意义(P均<0.05)。ROC曲线显示术前sd-LDL预测PCI术后发生CIN的AUC为0.755,最佳诊断界值为0.950 mmol/L。术前血清CysC预测PCI术后发生CIN的AUC为0.751,最佳诊断界值为1.055 mg/L。两者联合AUC为0.816。结论 术前sd-LDL和血清CysC水平是冠脉介入术后CIN早期预测指标,两者联合能提高对PCI术后CIN的预测价值,在实际临床工作中,有一定的预测价值。Objective To explore the effects of preoperative small dense low-density lipoprotein(sd-LDL)and serum cystatin C(CysC)levels on postoperative contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI).Methods The clinical data of 200 patients with coronary atherosclerotic heart disease(CHD)treated with PCI in Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2022 to April 2023 meeting the admission criteria were retrospectively selected.Based on serum creatinine(Scr)levels,patients were divided into con-trast nephropathy group(17 cases)and non-contrast nephropathy group(183 cases).ROC curves were drawn to evalu-ate the predictive value of sd-LDL,CysC,and their combination for CIN after PCI.Results Preoperative sd-LDL and serum CysC in CIN group were higher than those in non-CIN group,and the differences were statistically significant(P<0.05).ROC curve showed that the AUC of sd-LDL before surgery to predict CIN after PCI was 0.755,and the op-timal diagnostic threshold was 0.950mmol/L.The AUC of preoperative serum CysC for predicting CIN after PCI was 0.751,and the best diagnostic threshold was 1.055 mg/L.The combined AUC was 0.816.Conclusions Preoperative sd-LDL and serum CysC levels are early predictors of CIN after coronary intervention,and the combination of the two can improve the predictive value of CIN after PCI,and has certain predictive value in practical clinical work.

关 键 词：对比剂肾病 胱抑素C 冠状动脉粥样硬化性心脏病 小而低密度脂蛋白 经皮冠状动脉介入术 

分 类 号：R54[医药卫生—心血管疾病]