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白细胞计数对接受经皮冠状动脉介入治疗患者造影剂诱导的急性肾损伤发生的影响。

Impact of white blood cell count on the development of contrast-induced acute kidney injury in patients receiving percutaneous coronary intervention.

作者信息

Fu Chengxiao, Ouyang Chenxi, Yang Guoping, Li Jingle, Chen Guiyang, Cao Yu, Gong Liying

机构信息

Center of Clinical Pharmacology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

Department of Pharmacy, The First Affiliated Hospital of University Of South China, Hengyang, Hunan, China.

出版信息

PeerJ. 2024 Jun 28;12:e17493. doi: 10.7717/peerj.17493. eCollection 2024.

Abstract

This study aimed to investigate the efficacy of a pre-procedural white blood cell (WBC) count in the prediction of contrast-induced acute kidney injury (CI-AKI) risk in coronary artery disease patients receiving a percutaneous coronary intervention (PCI). This observational study comprises a sample of 1,013 coronary artery disease patients (including ACS and stable angina) receiving PCI, gathered from September 2015 to July 2017. CI-AKI incidence in the study population was 4.8% (49/1013). Patients in the CI-AKI group had significantly higher WBC counts than those in the non-CI-AKI group (10.41 ± 5.37 8.09 ± 3.10, = 0.004). Logistic analysis showed that WBC count (odds ratio [OR]: 1.12, 95% CI [1.03-1.21], = 0.006) was a significant and independent predictor of CI-AKI risk in patients receiving PCI, Receiver-operating characteristic (ROC) curve analysis found that pre-procedural WBC count ≥11.03*10/L was the optimal cut-off value in the prediction of CI-AKI risk with a sensitivity of 41.0% and a specificity of 86.5%. Patients with CI-AKI had a significantly worse 1-year survival rate than patients without CI-AKI (91.8% 97.6%, = 0.012). In summary, increased pre-procedural WBC count is associated with an increased risk of developing CI-AKI in patients receiving PCI.

摘要

本研究旨在探讨术前白细胞(WBC)计数对接受经皮冠状动脉介入治疗(PCI)的冠心病患者发生对比剂诱导的急性肾损伤(CI-AKI)风险的预测效能。这项观察性研究纳入了2015年9月至2017年7月期间接受PCI的1013例冠心病患者(包括急性冠状动脉综合征和稳定型心绞痛患者)。研究人群中CI-AKI的发生率为4.8%(49/1013)。CI-AKI组患者的白细胞计数显著高于非CI-AKI组(10.41±5.37对8.09±3.10,P=0.004)。逻辑分析显示,白细胞计数(优势比[OR]:1.12,95%置信区间[CI][1.03-1.21],P=0.006)是接受PCI患者发生CI-AKI风险的显著且独立预测因素。受试者工作特征(ROC)曲线分析发现,术前白细胞计数≥11.03×10⁹/L是预测CI-AKI风险的最佳截断值,敏感性为41.0%,特异性为86.5%。发生CI-AKI的患者1年生存率显著低于未发生CI-AKI的患者(91.8%对97.6%,P=0.012)。总之,术前白细胞计数升高与接受PCI患者发生CI-AKI的风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b0e/11636986/9b03048da8da/peerj-12-17493-g001.jpg

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