Wang Linsheng, Xu Yang, Zhang Xudong, Ding Jiahui, Jin Jingkun, Zong Jing, Li Fangfang, Qian Weidong, Li Wenhua
Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Department of Cardiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, People's Republic of China.
J Inflamm Res. 2024 Oct 2;17:7005-7016. doi: 10.2147/JIR.S482977. eCollection 2024.
Contrast-induced acute kidney injury (CI-AKI) refers to the acute renal dysfunction caused by the injection of contrast agents. CI-AKI is currently a common complication after percutaneous coronary intervention (PCI).
To investigate the predictive value of the combined systemic inflammatory index (SII) and urate/high-density lipoprotein cholesterol ratio (UHR) for CI-AKI after PCI in patients with AMI.
A total of 1222 patients with AMI who underwent PCI were randomly divided into a training group and a validation group in an 8:2 ratio. According to the definition of CI-AKI diagnostic criteria, the training group was divided into CI-AKI group and non-CI-AKI group. Collect patient's blood and biochemical data, then calculate SII and UHR. The risk factors for CI-AKI were identified using LASSO and multivariate logistic regression analyses. A predictive column was created by using R language.Evaluate the predictive value of SII, UHR and their combination for CI-AKI after PCI using the area under the ROC curve (AUC).
Diabetes, Cystatin C, Diuretics, UHR, and LnSII were independent risk factors for CI-AKI in AMI patients after PCI. The ROC curve showed that the AUC of UHR and SII combined for predicting CI-AKI in AMI patients after PCI was 0.761 (95% : 0.709-0.812), with a sensitivity of 65.20% and a specificity of 76.70%, which was better than the prediction by either factor alone.
High SII and high UHR are risk factors for AMI, and their combination can improve the accuracy of predicting CI-AKI in AMI patients after PCI.The prognosis of CI-AKI in AMI patients is worse than in the general population.
对比剂诱导的急性肾损伤（CI-AKI）是指因注射对比剂导致的急性肾功能障碍。CI-AKI是目前经皮冠状动脉介入治疗（PCI）后常见的并发症。
探讨全身炎症指标（SII）与尿酸/高密度脂蛋白胆固醇比值（UHR）联合检测对急性心肌梗死（AMI）患者PCI术后CI-AKI的预测价值。
将1222例行PCI的AMI患者按8∶2随机分为训练组和验证组。根据CI-AKI诊断标准定义，将训练组分为CI-AKI组和非CI-AKI组。收集患者血液及生化资料，计算SII和UHR。采用LASSO和多因素logistic回归分析确定CI-AKI的危险因素。用R语言建立预测模型。采用ROC曲线下面积（AUC）评估SII、UHR及其联合检测对PCI术后CI-AKI的预测价值。
糖尿病、胱抑素C、利尿剂、UHR及LnSII是AMI患者PCI术后发生CI-AKI的独立危险因素。ROC曲线显示，UHR与SII联合预测AMI患者PCI术后CI-AKI的AUC为0.761（95%：0.709～0.812），敏感度为65.20%，特异度为76.70%，优于单一指标预测。
高SII和高UHR是AMI患者PCI术后发生CI-AKI的危险因素，二者联合可提高预测AMI患者PCI术后CI-AKI的准确性。AMI患者CI-AKI的预后较一般人群差。
