【摘要】 目的:探讨造影剂用量与肾小球滤过率比值（CM/eGFR）对预测PCI术后造影剂肾病（CIN）发生的临床意义。方法:纳入2014年5月至2015年10月在南方医院行PCI手术的患者307例.根据术后72 h内是否发生CIN,分为CIN组（29例）、非CIN组（278例）,并根据术前血肌酐（sCr）、胱抑素C（CyC）浓度分别计算基础肾功能eGFR_MDRD、eGFR_CyC。结果:PCI术后造影剂肾病发生率9.4%（29/307）,基线资料显示CIN组在年龄、CM、NT_pro-BNP、IABP、围术期低血压、术前sCr及CyC均与非CIN组具有明显差异（P<0.05）。多因素Logistic分析显示年龄、心功能（≥Ⅲ级）、术后IABP、使用CCB、CM/eGFR_MDRD、CM/eGFR_CyC等因素均是影响CIN发生的独立相关因素,ROC曲线分析示CM/eGFR_MDRD曲线下面积为0.838、CM/eGFR_CyC曲线下面积为0.805,两者的AUC无统计学差异;灵敏度及特异度分别为79.3%、76.3%,CM/eGFR_MDRD临界值为2.095。结论:作为新指标的CM/eGFR_MDRD与CM/eGFR_CyC比值,均可作为目前评估造影剂最大剂量及预测PCI术后CIN发生的良好方法,且两者无明显差异。更多还原

【Abstract】 Objective To evaluate the significance of contrast medium（CM） volume and estimated glomerular filtration rate（CM/eGFR） in predicting contrast-induced nephropathy（CIN） after PCI.Methods A total of 307 patients after PCI were enrolled from Nanfang Hospital from May 2014 to October 2015.The patients were divided into the CIN group（n=29） and the non-CIN group（n=278） according to whether CIN within 72 hours after PCI.The baseline renal function was assessed by the sCr and CyC,respectively.Results Twentynine patients（9.4%,29/307） developed CIN.There were significant differences in Age,CM、NTpro-BNP、IABP、Periprocedural Hypotension、Preprocedural sCr/CyC between two groups（P<0.05,respectively）.The result of multivariate logistic regression analysis showed that Age,Cardiac function ≥Ⅲ level,IABP,use CCB,CM/eGFR_MDRD,CM/eGFR_CyC were independent risk predictors for CIN,respectively.Receiver Operating Characteristic（ROC） curve analysis showed that the area under the curve of CM/eGFR_MDRD（AUC= 0.838） was superior to CM/eGFR_CyC（AUC=0.805） without significant difference.The sensitivity and specificity were 79.3%and 76.3%（Cut-off Point=2.094）,respectively.Conclusion Both the CM/eGFR_MDRD and CM/eGFR_CyC may be good methods to determine maximum CM before PCI and to predict CIN after PCI currently,without significant differences between these two predictors.更多还原