[1]张昭,王仁学,毛琳霜,等.尿素氮/肌酐比值对于非ST段抬高急性冠脉综合征患者经皮冠脉介入术后对比剂肾病的预测价值[J].心血管病学进展,2021,(8):748-752.[doi:10.16806/j.cnki.issn.1004-3934.2021.08.018]
　ZHANG Zhao,WANG Renxue,MAO Linshuang,et al.Predictive Value of Urea-Nitrogen/Creatinine Ratio for Contrast Induced Nephropathy in Patients with Non-ST-Elevation Acute Coronary Syndrome after Percutaneous Coronary Intervention[J].Advances in Cardiovascular Diseases,2021,(8):748-752.[doi:10.16806/j.cnki.issn.1004-3934.2021.08.018]
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尿素氮/肌酐比值对于非ST段抬高急性冠脉综合征患者经皮冠脉介入术后对比剂肾病的预测价值()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2021年8期
页码:
748-752
栏目:
论著
出版日期:
2021-08-25

文章信息/Info

Title:
Predictive Value of Urea-Nitrogen/Creatinine Ratio for Contrast Induced Nephropathy in Patients with Non-ST-Elevation Acute Coronary Syndrome after Percutaneous Coronary Intervention
作者:
张昭1; 王仁学2; 毛琳霜2; 凌维维2; 吴丹2; 姜子超2; 刘康2; 钱赓2
(1.中国人民解放军总医院海南医院心血管内科,海南 三亚 5720142.中国人民解放军总医院第一医学中心心血管内科,北京100853)
Author(s):
ZHANG Zhao1;  WANG Renxue2;  MAO Linshuang2;  LING Weiwei2;  WU Dan2;  JIANG Zichao2;  QIAN Geng2
(1.Department of Cardiovascular Medicine,Hainan Hospital of PLA General Hospital ,Sanya 572014 ,Hainan,China 2.Department of Cardiovascular Medicine,Chinese PLA General Hospital,Beijing 100853,China)
关键词:
急性冠脉综合征; 危险因素; 对比剂肾病
Keywords:
Acute coronary syndrome Risk factor Contrast induced nephropathy
DOI:
10.16806/j.cnki.issn.1004-3934.2021.08.018
摘要:
目的 尿素氮/肌酐比（BUN/Cr）常作为反映患者容量状态的客观指标，本研究探讨冠脉介入术前BUN/Cr水平对急性冠脉综合征（ACS）患者接受经皮冠脉介入术后发生对比剂肾病（CIN）的预测价值。 方法 回顾性分析于中国人民解放军总医院心血管内科行择期经皮冠脉介入术的非ST段抬高急性冠脉综合征患者1 163例。根据围术期是否发生对比剂肾病分为CIN组（n=102例）和非CIN组（n=1 061例）。收集患者一般资料，基础病史以及血常规、肌酐和尿素氮等生化结果，造影结果以及超声心动图结果。采用Logistic回归分析术后发生CIN的危险因素。结果 1 163例患者中有102例发生CIN，发生率为8.77%。与非CIN组比较，CIN组中贫血、高BUN/Cr明显上升，心脏射血分数明显下降（P＜0.05)。Logistic回归分析显示术前高BUN/Cr是发生CIN的独立危险因素（OR 1.754，95% CI 1.160～2.651，P=0.008），其他的独立危险因素包括心力衰竭和高脂血症（P＜0.001，P＜0.05）。将高BUN/Cr代入传统CIN评分系统预测对比剂肾病的AUC为0.635（95% CI 0.575～0.696，P＜0.001）。结论 术前高BUN/Cr（BUN/Cr≥20）是CIN的独立预测因子，有助于早期识别CIN高危患者。
Abstract:
Objective The urea nitrogen to creatinine ratio (BUN/Cr) is often used as an objective indicator to reflect the patients volume status. The study investigates the predictive value of preoperative BUN/Cr level in the occurrence of contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A retrospective study was conducted on 1 163 patients with non-ST-segment elevation ACS who underwent elective PCI in the Department of Cardiology Medicine, the General Hospital of the Peoples Liberation Army. According to the occurrence of CIN during the perioperative period,the patients were allocated to CIN group (n=102 cases) and non-CIN group (n=1 061 cases). General data,basic medical history,angiography and echocardiography,biochemical tests including blood routine, creatinine and urea nitrogen were collected.Logistic regression was used to analyze the risk factors for CIN after operation. Results There were 102 cases of CIN among 1163 patients with the incidence of 8.77%. Compared with the non-CIN group,the incidence of anemia,high BUN/Cr increased and ejection fraction decreased were significantly higher in the CIN group (P＜0.05). Logistic regression analysis showed that preoperative high BUN/Cr level was an independent risk factor for CIN(OR 2.093,95% CI 1.281～3.419,P=0.003). Other independent risk factors for CIN included heart failure and hyperlipidemia (P＜0.001,P＜0.05). Area under the ROC curve (AUC) of predicting the contrast induced nephropathy is 0.635 when add BUN/Cr into CIN prediction model (95% CI 0.575～0.696,P＜0.001). Conclusion Preoperative high BUN/Cr (BUN/Cr≥20) is an independent predictor for CIN after PCI, which is helpful for early identification of high-risk patients.

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备注/Memo

备注/Memo:
基金项目：首都卫生发展科研专项（首发2020-2-5012） 通信作者：钱赓，Email：qiangeng9396@263.net 收稿时间：2021-04-16
更新日期/Last Update: 2021-09-26