肾动脉阻力指数联合Cys C、Scr、Ure、UA对PCI术后造影剂肾病的预测价值  

Predictive Value of Renal Artery Resistance Index Combined with Cys C,Scr,Ure and UA for Contrast Induced Nephropathy After PCI

作　　者：韩丹 杜夏 HAN Dan;DU Xia(Department of Nephrology,Tangdu Hospital,Air Force Military Medical University,Xi'an Shaanxi 721000,China)

机构地区：[1]空军军医大学唐都医院肾脏内科,陕西西安721000

出　　处：《联勤军事医学》2024年第11期946-951,共6页Military Medicine of Joint Logistics

摘　　要：目的 探讨肾动脉阻力指数(renal artery resistance index,RRI)联合血胱抑素C(cystatin C,Cys C)、血肌酐(serum creatinine,Scr)、血尿素(urea,Ure)、血尿酸(uric acid,UA)对经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后造影剂肾病的预测价值。方法 选取2021-06/2022-06月在作者医院行PCI的191例冠状动脉粥样硬化性心脏病(以下简称为冠心病)患者,均于造影前24 h及造影后1、24 h检测RRI,另于造影前24 h及造影后12、24、48 h检测外周血Cys C、Scr、Ure、UA水平。将术后明确诊断为造影剂肾病的患者归为造影剂肾病组,其余归为对照组,对比两组各时间点RRI、Cys C、Scr、Ure、UA水平;采用多因素Logistic回归分析法分析PCI术后造影剂肾病发生的相关风险因素,并应用受试者工作特征(receiver operating characteristic,ROC)曲线评估造影前24 h的RRI联合Cys C、Scr、Ure、UA预测造影剂肾病的价值。结果 PCI术后造影剂肾病发生率为10.99%(21/191)。单独效应分析结果显示,造影剂肾病组造影前24 h、造影后1 h、造影后24 h患者的RRI水平均高于对照组(P均<0.05);同一组内,造影剂肾病组造影后1 h患者的RRI高于造影前24 h,造影后24 h的RRI低于造影前24 h及造影后1 h(P均<0.05)。单独效应分析结果显示,造影剂肾病组患者Cys C、Scr、Ure、UA水平在造影前24 h、造影后12 h、造影后24 h、造影后48 h均高于对照组(P均<0.05);同一组内,造影剂肾病组Cys C、Scr、Ure、UA水平在组内造影后12、24、48 h均高于造影前24 h(P均<0.05),造影后24、48 h均高于造影后12 h(P均<0.05),Cys C、Ure、UA水平在组内造影后48 h均低于造影后24 h(P均<0.05),Scr水平在造影后48 h高于造影后24 h(P均<0.05)。经多因素Logistic回归分析结果显示,年龄、高血压史、糖尿病史、造影剂用量及造影前24 h的RRI、Cys C、Scr、Ure、UA水平均是冠心病患者PCI术后发生造影剂肾病的风险因素(P<0.05)。根据ROC�Objective To investigate the predictive value of renal artery resistance index(RRI) combined with cystatin C(Cys C),serum creatinine(Scr),blood urea(Ure) and blood uric acid(UA) in the prediction of contrast induced nephropathy after percutaneous coronary intervention(PCI).Methods A total of 191 patients with coronary atherosclerotic heart disease underwent PCI in author′s hospital from June 2021 to June 2022 were selected,and the levels RRI were detected at 24 h before angiography and 1 h,24 h after angiography,and the levels of Cys C,Scr,Ure and UA in peripheral blood were also detected at 24 h before angiography and 12 h,24 h,48 h after angiography.The patients definitely diagnosed as contrast nephropathy after operation were classified into contrast nephropathy group,and the rest were classified into control group,and the levels of RRI,Cys C,Scr,Ure and UA of the two groups at each time point were compared;and the multivariate Logistic regression analysis method was used to analyze the risk factors of contrast induced nephropathy after PCI,then receiver operating characteristic(ROC) curve was used to evaluate the value of RRI combined with Cys C,Scr,Ure and UA at 24 h before angiography in predicting contrast induced nephropathy.Results The incidence rate of contrast induced nephropathy after PCI was 10.99%(21/191).The results of single effect analysis showed that RRI levels in contrast nephropathy group were higher than those in control group at 24 h before,1 h and 24 h after angiography(all P<0.05);the RRI at 1 h after angiography was higher than 24 h before angiography,and the RRI at 24 h after angiography was lower than 24 h before and 1 h after angiography of patients in contrast nephropathy group(all P<0.05).The results of single effect analysis showed that the levels of Cys C,Scr,Ure and UA in contrast nephropathy group were higher than those in control group at 24 h before,12 h,24 h and 48 h after angiography(all P<0.05);in contrast nephropathy group the levels of Cys C,Scr,Ure and UA at 12 h,24 h a

关 键 词：经皮冠状动脉介入术 造影剂肾病 肾动脉阻力指数 胱抑素C 血肌酐 尿素 尿酸 预测价值 

分 类 号：R692.5[医药卫生—泌尿科学]