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Mehran 对比剂相关急性肾损伤风险评分:它适用于亚洲经皮冠状动脉介入治疗人群吗?

Mehran 2 Contrast-Associated Acute Kidney Injury Risk Score: Is it Applicable to the Asian Percutaneous Coronary Intervention Population?

机构信息

Department of Radiology, 117890Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China.

Department of Pharmacy, 117890Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China.

出版信息

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221116353. doi: 10.1177/10760296221116353.

Abstract

Contrast-associated acute kidney injury (CA-AKI) can occur after percutaneous coronary intervention (PCI). The Mehran score is the gold standard for predicting CA-AKI risk, and it has recently been updated. The Mehran 2 CA-AKI risk score, based on existing variables in patients undergoing PCI, can accurately differentiate the risk of CA-AKI. This study aimed to verify whether the new Mehran score is applicable to the Asian PCI population. The study included the clinical data of 2487 patients undergoing PCI from August 2020 to February 2022. The goodness-of-fit test (Hosmer-Lemeshow) was used to evaluate the correction ability of the Mehran 2 score, and the area under the receiver operating characteristic curve (ROC) was used to evaluate the accuracy of the Mehran 2 score in predicting CA-AKI. CA-AKI occurred in 28 of 2487 patients, with an incidence rate of 1.12%. The proportion of high risk factors for AKI in the cohort was lower than that in the Mehran 2 cohort (a large contemporary PCI cohort to develop the Mehran 2 score). The Mehran 2 risk score had excellent goodness-of-fit (χ2 = 5.320, df = 6, P = 0.503) and high predictive accuracy (area under the ROC curve 0.836, P < 0.0001). The Mehran 2 score shows good predictive and correction performance in the Asian population and has good clinical application value. The inclusion of the Mehran 2 risk score in patients hospitalised for coronary angiography appears to be good practice.

摘要

对比剂相关急性肾损伤(CA-AKI)可发生于经皮冠状动脉介入治疗(PCI)后。 Mehran 评分是预测 CA-AKI 风险的金标准,且最近已进行了更新。基于行 PCI 患者的现有变量的 Mehran 2 CA-AKI 风险评分可准确区分 CA-AKI 风险。本研究旨在验证新的 Mehran 评分是否适用于亚洲 PCI 人群。该研究纳入了 2020 年 8 月至 2022 年 2 月行 PCI 的 2487 例患者的临床数据。采用拟合优度检验(Hosmer-Lemeshow)评估 Mehran 2 评分的校正能力,采用受试者工作特征曲线(ROC)下面积评估 Mehran 2 评分预测 CA-AKI 的准确性。2487 例患者中 28 例(1.12%)发生 CA-AKI。该队列 AKI 高危因素的比例低于 Mehran 2 队列(开发 Mehran 2 评分的大型当代 PCI 队列)。Mehran 2 风险评分具有良好的拟合优度(χ2=5.320,df=6,P=0.503)和较高的预测准确性(ROC 曲线下面积 0.836,P<0.0001)。Mehran 2 评分在亚洲人群中具有良好的预测和校正性能,具有良好的临床应用价值。将 Mehran 2 风险评分纳入行冠状动脉造影检查的患者似乎是一种良好的实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bda7/9358571/a04ab5057ceb/10.1177_10760296221116353-fig2.jpg

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