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尿酸是预测造影剂肾病的有用工具。

Uric Acid is a Useful Tool to Predict Contrast-Induced Nephropathy.

作者信息

Mendi Mehmet Ali, Afsar Baris, Oksuz Fatih, Turak Osman, Yayla Cagri, Ozcan Firat, Johnson Richard J, Kanbay Mehmet

机构信息

1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.

2 Department of Nephrology, Konya Numune Hospital, Konya, Turkey.

出版信息

Angiology. 2017 Aug;68(7):627-632. doi: 10.1177/0003319716639187. Epub 2016 Mar 22.

Abstract

Developing contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (pPCI) has a negative impact on survival and morbidity. We assessed the predictive value of serum uric acid (SUA) for the development of CIN in patients with ST-segment elevation myocardial infarction (STEMI) who underwent pPCI. Contrast-induced nephropathy was defined an increase of ≥25% or ≥0.5 mg/dL in creatinine concentrations within 72 hours after pPCI. Patients were divided into 2 groups according to admission median SUA level. Serum uric acid level was <5.4 mg/dL (group 1; n = 222) and ≥5.4 mg/dL (group 2; n = 228). Compared to group 1, development of CIN (12% vs 20%, P < .001) was significantly greater in group 2. Using a cut point of >5.45 mg/dL, the SUA level predicted development of CIN with a sensitivity of 70% and specificity of 67%. In multiple logistic regression analysis, SUA level, diabetes mellitus, left ventricular ejection fraction <50%, contrast volume, estimated glomerular filtration rate, and C-reactive protein level emerged as independent predictors of CIN. In conclusion, elevated SUA is an independent risk factor for the development of CIN after pPCI in patients with STEMI.

摘要

在直接经皮冠状动脉介入治疗(pPCI)后发生对比剂肾病(CIN)对生存率和发病率有负面影响。我们评估了血清尿酸(SUA)对接受pPCI的ST段抬高型心肌梗死(STEMI)患者发生CIN的预测价值。对比剂肾病定义为pPCI后72小时内肌酐浓度升高≥25%或≥0.5mg/dL。根据入院时SUA中位数水平将患者分为两组。血清尿酸水平<5.4mg/dL(第1组;n = 222)和≥5.4mg/dL(第2组;n = 228)。与第1组相比,第2组CIN的发生率(12%对20%,P <.001)显著更高。使用>5.45mg/dL的切点,SUA水平预测CIN发生的敏感性为70%,特异性为67%。在多因素逻辑回归分析中,SUA水平、糖尿病、左心室射血分数<50%、对比剂用量、估计肾小球滤过率和C反应蛋白水平是CIN的独立预测因素。总之,SUA升高是STEMI患者pPCI后发生CIN的独立危险因素。

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