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女性与心肌梗死中的急性肾损伤。

Women and acute kidney injury in myocardial infarction.

机构信息

Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia.

Herzzentrum Leipzig, Strümpellstraße 39, Leipzig, Germany.

出版信息

J Nephrol. 2018 Oct;31(5):713-719. doi: 10.1007/s40620-018-0504-4. Epub 2018 Jun 12.

Abstract

BACKGROUND

Data on the relationship between gender and acute kidney injury (AKI) in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) are conflicting and inconclusive. The contrast volume-to-estimated glomerular filtration rate ratio (CV/GFR) was shown to predict AKI in patients with MI undergoing PCI. We assessed gender-based differences in AKI and evaluated the association between the CV/GFR and AKI in MI patients undergoing PCI.

METHODS

We retrospectively studied 4675 consecutive patients with MI who underwent PCI between January 2007 and December 2015. The incidence of AKI and CV/GFR in men and women were compared. Data were analyzed using descriptive statistics.

RESULTS

Women suffered more AKI than men [152 (10.5%) women suffered AKI compared to 252 (7.8%) men; p = 0.003]. After adjustment for potential confounders, female gender was identified as an independent predictive factor for AKI. CV/GFR was higher in women (2.57 ± 1.95 in women vs. 2.25 ± 1.60 in men; p < 0.0001) and predicted AKI.

CONCLUSION

AKI occurs more often in women than men with MI undergoing PCI. Female gender independently predicted AKI in our analysis. A high CV/GFR denotes a group of patients who are at higher risk of AKI after PCI. CV/GFR was significantly higher in women, which may help to explain their worse outcome as regards AKI.

摘要

背景

经皮冠状动脉介入治疗(PCI)的心肌梗死(MI)患者中,性别与急性肾损伤(AKI)的关系数据存在争议且尚无定论。对比剂体积与估算肾小球滤过率比值(CV/GFR)可预测行 PCI 的 MI 患者的 AKI。我们评估了 PCI 的 MI 患者中 AKI 的性别差异,并评估了 CV/GFR 与 AKI 之间的关联。

方法

我们回顾性研究了 2007 年 1 月至 2015 年 12 月间 4675 例连续接受 PCI 的 MI 患者。比较了男性和女性 AKI 的发生率及 CV/GFR。使用描述性统计分析数据。

结果

女性 AKI 的发生率高于男性[152(10.5%)例女性发生 AKI,而 252(7.8%)例男性发生 AKI;p=0.003]。在调整了潜在混杂因素后,女性性别被确定为 AKI 的独立预测因素。女性的 CV/GFR 更高(女性 2.57±1.95,男性 2.25±1.60;p<0.0001),且预测 AKI。

结论

与行 PCI 的 MI 男性患者相比,女性患者更常发生 AKI。在我们的分析中,女性性别独立预测 AKI。高 CV/GFR 表示 PCI 后 AKI 风险较高的患者群体。女性的 CV/GFR 明显更高,这可能有助于解释她们 AKI 预后更差。

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