Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Circ J. 2013;77(2):484-9. doi: 10.1253/circj.cj-12-0640. Epub 2012 Oct 31.
Urinary β2 microglobulin (U-β2MG) is a more sensitive and accurate marker of tubulointerstitial damage. The etiology of glomerular damage is related to the occurrence of major adverse cardiovascular events (MACE) in patients with myocardial infarction (MI); however, the prognostic importance of tubulointerstitial damage in patients with ST-segment elevation MI (STEMI) has not been established. The aim of this study was to elucidate whether renal tubulointerstitial damage is associated with the occurrence of MACE in patients after STEMI undergoing percutaneous coronary intervention.
The degree of renal tubulointerstitial damage was evaluated by measuring the U-β2MG level in 89 consecutive STEMI patients. There were 22 MACEs during the follow-up period. Patients with MACE had higher U-β2MG levels than those without MACE, and the U-β2MG level was an independent predictor for MACE. A Kaplan-Meier analysis revealed that the group with higher U-β2MG levels corrected for urinary creatinine was associated with a greater risk for MACE.
An elevated U-β2MG level was associated with the occurrence of MACE in STEMI patients who underwent PCI. Renal tubulointerstitial damage is therefore considered to be associated with the occurrence of MACE.
尿β2 微球蛋白（U-β2MG）是一种更敏感、更准确的肾小管间质损伤标志物。肾小球损伤的病因与心肌梗死（MI）患者发生主要不良心血管事件（MACE）有关；然而，ST 段抬高型心肌梗死（STEMI）患者肾小管间质损伤的预后意义尚未确定。本研究旨在阐明经皮冠状动脉介入治疗（PCI）后的 STEMI 患者发生肾间质小管损伤是否与 MACE 的发生有关。
通过测量 89 例连续 STEMI 患者的 U-β2MG 水平来评估肾间质小管损伤程度。在随访期间发生了 22 例 MACE。发生 MACE 的患者 U-β2MG 水平高于未发生 MACE 的患者，U-β2MG 水平是 MACE 的独立预测因子。Kaplan-Meier 分析显示，校正尿肌酐后 U-β2MG 水平较高的组与 MACE 风险增加相关。
校正尿肌酐后 U-β2MG 水平升高与接受 PCI 的 STEMI 患者发生 MACE 有关。因此，认为肾小管间质损伤与 MACE 的发生有关。
