尿脂联素水平升高与择期经皮冠状动脉介入治疗患者的造影剂肾病相关。

Increased urinary adiponectin level is associated with contrast-induced nephropathy in patients undergoing elective percutaneous coronary intervention.

机构信息

Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 15 Changle West Road, Xi'an, 710032, Shannxi, China.

出版信息

BMC Cardiovasc Disord. 2019 Jul 3;19(1):160. doi: 10.1186/s12872-019-1143-y.

DOI:10.1186/s12872-019-1143-y

PMID:31269899

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6610850/

Abstract

BACKGROUND

Contrast-induced nephropathy (CIN) is one of major and serious complications in patients undergoing percutaneous coronary intervention (PCI). It is unknown whether increased urinary adiponectin (UAPN), a sensitive marker for early renal function impairment, is associated with an increased risk of CIN. Therefore, we prospectively investigate the association of UAPN with CIN.

METHODS

We prospectively enrolled 208 patients who were undergoing elective PCI. The baseline UAPN was assessed prior to PCI. The ROC analysis was used to evaluate the predictive value of UAPN for CIN. Multivariate logistic regression analysis was performed to analyze the independent risk factors for CIN.

RESULTS

Of 208 patients, CIN occurred in 19 patients (9.13%), and 6 of them (2.88%) required dialysis. Patients with CIN had a higher UAPN level than those without CIN (17.15 ± 12.36 vs. 10.29 ± 3.04 ng/ml, P < 0.01). ROC analysis showed that the optimal cutoff value of UAPN for predicting CIN was 12.24 ng/ml with 68.42% sensitivity and 76.72% specificity (AUC = 0.7204; 95% CI, 0.582-0.859; 푃< 0.01). Multivariate analysis demonstrated that UAPN (OR, 5.071; 95% CI,1.711-15.028; P < 0.01) and serum creatinine (Scr) > 124 μmol/L (OR, 4.210; 95% CI, 1.297-13.669; P < 0.01) were independently associated with CIN.

CONCLUSIONS

Our present study showed that a higher baseline UAPN (≥12.24 ng/ml) level was significantly associated with an increased risk for developing CIN post PCI.

摘要

背景

对比剂诱导的肾病（CIN）是经皮冠状动脉介入治疗（PCI）患者的主要且严重的并发症之一。目前尚不清楚尿脂联素（UAPN）的升高是否与 CIN 风险增加有关，UAPN 是早期肾功能损害的敏感标志物。因此，我们前瞻性地研究了 UAPN 与 CIN 的关系。

方法

我们前瞻性地纳入了 208 例行择期 PCI 的患者。在 PCI 前评估基线 UAPN。ROC 分析用于评估 UAPN 预测 CIN 的价值。多变量 logistic 回归分析用于分析 CIN 的独立危险因素。

结果

208 例患者中，19 例（9.13%）发生 CIN，其中 6 例（2.88%）需要透析。发生 CIN 的患者 UAPN 水平高于未发生 CIN 的患者（17.15±12.36 vs. 10.29±3.04ng/ml，P<0.01）。ROC 分析显示，UAPN 预测 CIN 的最佳截断值为 12.24ng/ml，灵敏度为 68.42%，特异性为 76.72%（AUC=0.7204；95%CI，0.582-0.859；P<0.01）。多变量分析表明，UAPN（OR，5.071；95%CI，1.711-15.028；P<0.01）和血清肌酐（Scr）>124μmol/L（OR，4.210；95%CI，1.297-13.669；P<0.01）与 CIN 独立相关。