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血尿酸白蛋白比值可预测行直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者对比剂肾病。

Serum Uric Acid to Albumin Ratio Can Predict Contrast-Induced Nephropathy in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

机构信息

Van Education and Research Hospital, Van, Turkey.

Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey.

出版信息

Angiology. 2023 Jan;74(1):70-78. doi: 10.1177/00033197221091605. Epub 2022 Apr 22.

DOI:10.1177/00033197221091605
PMID:35451314
Abstract

Contrast-induced nephropathy (CIN) is one of the common complication of ST-elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI). Serum uric acid to albumin ratio (UAR) is a novel marker, which is associated with acute kidney injury in intensive care unit patients. We investigated the predictive value of UAR for the development of CIN in STEMI patients (n = 1379) after pPCI. The diagnosis of CIN was made based on an increase of basal creatinine levels >.5 mg/dL or 25% within 72 h after pPCI; 128 patients were in the CIN (+) group and 1251 patients were in the CIN (-) group. CIN (+) patients had higher serum uric acid (SUA), UAR, and lower albumin levels than CIN (-) patients. Age, diabetes, hypertension, hemoglobin, glucose at admission, basal creatinine, peak troponin I, total bilirubin, contrast volume/glomerular filtration rate, and UAR were independent predictors of CIN. A cutoff value of 1.62 for UAR detected CIN development with a sensitivity of 54% and specificity of 87.4%, and the discrimination ability of UAR was better than that of SUA or albumin. In conclusion, UAR was an independent predictor of the development of CIN.

摘要

对比剂肾病(CIN)是经皮冠状动脉介入治疗(pPCI)后 ST 段抬高型心肌梗死(STEMI)的常见并发症之一。尿酸与白蛋白比值(UAR)是一种新型标志物,与重症监护病房患者急性肾损伤相关。我们研究了 UAR 对 pPCI 后 STEMI 患者(n=1379)发生 CIN 的预测价值。CIN 的诊断基于 pPCI 后 72 小时内基础肌酐水平升高>.5 mg/dL 或 25%;128 例患者为 CIN(+)组,1251 例患者为 CIN(-)组。CIN(+)患者的血清尿酸(SUA)、UAR 水平较高,白蛋白水平较低。年龄、糖尿病、高血压、血红蛋白、入院时血糖、基础肌酐、肌钙蛋白 I 峰值、总胆红素、对比剂用量/肾小球滤过率和 UAR 是 CIN 的独立预测因素。UAR 的截断值为 1.62 时,检测 CIN 发展的敏感性为 54%,特异性为 87.4%,UAR 的鉴别能力优于 SUA 或白蛋白。总之,UAR 是 CIN 发展的独立预测因素。

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