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炎症生物标志物与行经皮冠状动脉介入治疗的急性冠脉综合征患者对比剂诱导急性肾损伤的相关性:一项横断面研究。

Association Between Inflammatory Biomarkers and Contrast-induced Acute Kidney Injury in ACS Patients Undergoing Percutaneous Coronary Intervention: A Cross-sectional Study.

机构信息

Medical School of Southeast University, Nanjing, China.

Department of Cardiology, School of Medicine, Southeast University Zhongda Hospital, Nanjing, China.

出版信息

Angiology. 2024 Oct;75(9):831-840. doi: 10.1177/00033197231185445. Epub 2023 Jun 19.

DOI:10.1177/00033197231185445
PMID:37337375
Abstract

The present study aimed to evaluate the predictive role of inflammatory biomarkers in the development of contrast-induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The inflammatory biomarkers assessed were: platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), neutrophil-to-lymphocyte*platelet ratio (NLPR), systemic inflammatory index (SII), and systemic inflammation response index (SIRI). Overall, 950 patients undergoing PCI were enrolled. The frequency of CI-AKI was 15.2% (n = 144). The levels of NLR, MLR, NLPR, SII, and SIRI were higher in the CI-AKI group than in the Non-CI-AKI group (P < .05). The addition of NLR ≥2.96, dNLR ≥2.08, NLPR ≥.012, SII ≥558.04, and SIRI ≥1.13 to the Mehran score model significantly increased the area under the curve (P < .05). Multivariable logistic regression analyses indicated that inflammatory biomarkers were significantly associated with CI-AKI, including NLR ≥2.96 (OR = 1.588, P = .017), dNLR ≥2.08 (OR = 1.686, P = .007), SII ≥558.04 (OR = 1.521, P = .030), and SIRI ≥1.13 (OR = 1.601, P = .017). Therefore, inflammation is associated with the development of CI-AKI, and preoperative hematological inflammatory markers could predict the risk of CI-AKI in ACS patients undergoing PCI.

摘要

本研究旨在评估炎症生物标志物在接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者中对比剂诱导的急性肾损伤(CI-AKI)发展中的预测作用。评估的炎症生物标志物包括血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、中性粒细胞与淋巴细胞比值(NLR)、衍生中性粒细胞与淋巴细胞比值(dNLR)、中性粒细胞与淋巴细胞*血小板比值(NLPR)、全身炎症指数(SII)和全身炎症反应指数(SIRI)。共有 950 名接受 PCI 的患者入组。CI-AKI 的发生率为 15.2%(n=144)。CI-AKI 组的 NLR、MLR、NLPR、SII 和 SIRI 水平均高于非 CI-AKI 组(P<.05)。将 NLR≥2.96、dNLR≥2.08、NLPR≥.012、SII≥558.04 和 SIRI≥1.13 加入 Mehran 评分模型显著增加了曲线下面积(P<.05)。多变量逻辑回归分析表明,炎症生物标志物与 CI-AKI 显著相关,包括 NLR≥2.96(OR=1.588,P=.017)、dNLR≥2.08(OR=1.686,P=.007)、SII≥558.04(OR=1.521,P=.030)和 SIRI≥1.13(OR=1.601,P=.017)。因此,炎症与 CI-AKI 的发生有关,术前血液学炎症标志物可预测 ACS 患者 PCI 后 CI-AKI 的风险。

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