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全免疫炎症值在预测因非ST段抬高型心肌梗死接受经皮冠状动脉介入治疗患者造影剂诱导的肾病发生中的作用

The Role of Pan-Immune-Inflammation Value in Predicting Contrast-Induced Nephropathy Development in Patients Undergoing Percutaneous Coronary Intervention Due to NSTEMI.

作者信息

Cetinkaya Zeki, Kelesoglu Saban

机构信息

Department of Cardiology, Elazıg Fethi Sekin City Hospital, Elazıg, Turkey.

Department of Cardiology, Erciyes University Faculty of Medicine, Melikgazi, Turkey.

出版信息

Angiology. 2025 Mar;76(3):281-288. doi: 10.1177/00033197231211107. Epub 2023 Oct 30.

DOI:10.1177/00033197231211107
PMID:37903550
Abstract

Contrast-induced nephropathy (CIN), which can develop after procedures involving contrast agents, is a significant cause of patient morbidity and mortality. This study aims to investigate the role of pre-procedural pan-immune-inflammation value (PIV) in predicting CIN development in patients undergoing percutaneous coronary intervention (PCI) due to non-ST segment elevation myocardial infarction (NSTEMI). A total of 1006 NSTEMI patients were included in the study. CIN was defined as an increase of at least 0.5 mg/dl or 25% in serum baseline creatinine level 72 h after the procedure. Patients were divided into two groups: those with and without CIN. NSTEMI patients who developed CIN, glucose level ( = .01), platelet count ( < .01), monocyte count ( < .001), neutrophil-to-lymphocyte ratio (NLR) ( < .001), systemic immune inflammation index (SII) score ( < .001), and PIV ( < .001) were higher compared with those without CIN. In the multivariate analysis of all these parameters, the Odds ratios of PIV and SII were similar and slightly lower than NLR. Receiver operating characteristic curve analysis (ROC) showed a PIV cut-off value of 448.43 with a sensitivity of 83.1% and a specificity of 72.8% in patients with CIN. Our study demonstrated an independent relationship between PIV at admission and CIN development in NSTEMI patients.

摘要

造影剂肾病(CIN)可在涉及造影剂的检查后发生,是导致患者发病和死亡的重要原因。本研究旨在探讨术前全免疫炎症值(PIV)在预测因非ST段抬高型心肌梗死(NSTEMI)接受经皮冠状动脉介入治疗(PCI)的患者发生CIN中的作用。共有1006例NSTEMI患者纳入本研究。CIN定义为术后72小时血清肌酐基线水平至少升高0.5mg/dl或25%。患者分为两组:发生CIN的患者和未发生CIN的患者。发生CIN的NSTEMI患者的血糖水平(P = 0.01)、血小板计数(P < 0.01)、单核细胞计数(P < 0.001)、中性粒细胞与淋巴细胞比值(NLR)(P < 0.001)、全身免疫炎症指数(SII)评分(P < 0.001)和PIV(P < 0.001)均高于未发生CIN的患者。在对所有这些参数进行多变量分析时,PIV和SII的比值比相似且略低于NLR。受试者工作特征曲线分析(ROC)显示,CIN患者的PIV临界值为448.43,敏感性为83.1%,特异性为72.8%。我们的研究表明,NSTEMI患者入院时的PIV与CIN发生之间存在独立关系。

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