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高尿酸血症是接受经皮冠状动脉介入治疗患者发生造影剂诱导的急性肾损伤和死亡的独立预测因素。

Hyperuricemia Is an Independent Predictor of Contrast-Induced Acute Kidney Injury and Mortality in Patients Undergoing Percutaneous Coronary Intervention.

作者信息

Guo Wei, Liu Yong, Chen Ji-Yan, Chen Shi-Qun, Li Hua-Long, Duan Chong-Yang, Liu Yuan-Hui, Tan Ning

机构信息

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Department of Biostatistics, Guangdong Society of Interventional Cardiology, Guangzhou, China.

出版信息

Angiology. 2015 Sep;66(8):721-6. doi: 10.1177/0003319714568516. Epub 2015 Jan 23.

Abstract

We investigated whether hyperuricemia is an independent predictor of contrast-induced acute kidney injury (CI-AKI) and mortality in patients undergoing percutaneous coronary intervention (PCI). In a single-center study of 1772 patients undergoing PCI, the development of CI-AKI and mortality during a 2.8-year median follow-up period was assessed. The incidence of CI-AKI was significantly higher in the hyperuricemic group than in the normouricemic group (5.78% vs 1.76%, P < .001). According to multivariate analysis (after adjusting for potential confounding factors), hyperuricemia predicted CI-AKI (odds ratio: 1.962; 95% confidence interval [CI]: 1.014-3.798; P = .045). The other risk factors for CI-AKI were >75 years, emergent PCI, chronic kidney disease (CKD), and anemia. Hyperuricemia with a tendency toward significantly independently predicted long-term mortality, after adjusting for CI-AKI, CKD, and emergent PCI (hazard ratio: 1.571; 95% CI: 1.006-2.452; P = .047). In patients undergoing PCI, hyperuricemia is associated with a risk of CI-AKI. Furthermore, after adjusting for other variables, including CI-AKI and CKD, long-term mortality after PCI was higher in those with hyperuricemia than with normouricemia.

摘要

我们调查了高尿酸血症是否是接受经皮冠状动脉介入治疗(PCI)患者发生对比剂诱导的急性肾损伤(CI-AKI)和死亡的独立预测因素。在一项对1772例接受PCI患者的单中心研究中,评估了在2.8年中位随访期内CI-AKI的发生情况和死亡率。高尿酸血症组CI-AKI的发生率显著高于正常尿酸血症组(5.78%对1.76%,P<0.001)。根据多变量分析(在调整潜在混杂因素后),高尿酸血症可预测CI-AKI(比值比:1.962;95%置信区间[CI]:1.014-3.798;P=0.045)。CI-AKI的其他危险因素为年龄>75岁、急诊PCI、慢性肾脏病(CKD)和贫血。在调整CI-AKI、CKD和急诊PCI后,有显著独立预测长期死亡率趋势的高尿酸血症(风险比:1.571;95%CI:1.006-2.452;P=0.047)。在接受PCI的患者中,高尿酸血症与CI-AKI风险相关。此外,在调整包括CI-AKI和CKD在内的其他变量后,高尿酸血症患者PCI后的长期死亡率高于正常尿酸血症患者。

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