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中性粒细胞与高密度脂蛋白比值对接受直接经皮冠状动脉介入治疗的急性心肌梗死患者造影剂诱导的急性肾损伤的预测价值

Predictive Value of Neutrophil to High-Density Lipoprotein Ratio for Contrast-Induced Acute Kidney Injury for Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

作者信息

Wang Zhen, Li Yanan, Shen Guoqi, Qiu Hang, Zhu Yinghua, Zheng Di, Li Wenhua

机构信息

Institute of Cardiovascular Diseases, Xuzhou Medical University, 221000 Xuzhou, Jiangsu, China.

Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 221000 Xuzhou, Jiangsu, China.

出版信息

Rev Cardiovasc Med. 2023 Feb 10;24(2):59. doi: 10.31083/j.rcm2402059. eCollection 2023 Feb.

Abstract

BACKGROUND

To investigate the incidence of contrast-induced acute kidney injury (CI-AKI) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) in relation to the neutrophil to high-density lipoprotein cholesterol ratio (NHR), and to further compare the predictive value of NHR and the neutrophil to lymphocyte ratio (NLR) for CI-AKI.

METHODS

We retrospectively analyzed 1243 AMI patients undergoing PCI from January 2019 to December 2021, and collected creatinine within 72 h after PCI. All patients were divided into a CI-AKI group and non-CI-AKI group according to the definition of CI-AKI, and the clinical information of the two groups was compared. Potential risk factors for CI-AKI in AMI patients undergoing primary PCI were screened by using logistic regression analysis, and receiver operating characteristic (ROC) curves were used to compare the predictive value of NHR and NLR.

RESULTS

A high NHR and high NLR were correlated with a high incidence of CI-AKI in AMI patients undergoing primary PCI, and NHR (odds ratio (OR): 1.313, 95% confidence interval (CI): 1.199-1.438) and NLR (OR: 1.105, 95% CI: 1.041-1.174) were independent risk factors for CI-AKI ( 0.05). Compared with NLR, the area under the curve (AUC) of NHR was larger (AUC = 0.668, 95% CI: 0.641-0.694 vs. AUC = 0.723, 95% CI: 0.697-0.748), and the difference was significant ( 0.05), with higher sensitivity (61.67% vs. 70.83%) and specificity (64.91% vs. 66.10%).

CONCLUSIONS

Compared with the NLR, the NHR is more valuable in predicting the incidence of CI-AKI in AMI patients undergoing primary PCI.

摘要

背景

探讨急性心肌梗死(AMI)患者接受直接经皮冠状动脉介入治疗(PCI)时,对比剂诱导的急性肾损伤(CI-AKI)的发生率与中性粒细胞与高密度脂蛋白胆固醇比值(NHR)的关系,并进一步比较NHR和中性粒细胞与淋巴细胞比值(NLR)对CI-AKI的预测价值。

方法

回顾性分析2019年1月至2021年12月期间接受PCI的1243例AMI患者,并收集PCI术后72小时内的肌酐值。根据CI-AKI的定义将所有患者分为CI-AKI组和非CI-AKI组,比较两组的临床资料。采用逻辑回归分析筛选直接PCI的AMI患者发生CI-AKI的潜在危险因素,并使用受试者工作特征(ROC)曲线比较NHR和NLR的预测价值。

结果

高NHR和高NLR与接受直接PCI的AMI患者CI-AKI的高发生率相关,NHR(比值比(OR):1.313,95%置信区间(CI):1.199-1.438)和NLR(OR:1.105,95%CI:1.041-1.174)是CI-AKI的独立危险因素(P<0.05)。与NLR相比,NHR的曲线下面积(AUC)更大(AUC = 0.668,95%CI:0.641-0.694 vs. AUC = 0.723,95%CI:0.697-0.748),差异有统计学意义(P<0.05),敏感性(61.67%对70.83%)和特异性(64.91%对66.10%)更高。

结论

与NLR相比,NHR在预测接受直接PCI的AMI患者CI-AKI的发生率方面更有价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f40/11273179/f04ce940c85e/2153-8174-24-2-059-g1.jpg

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