CAJ | 학술논문

目的：探讨非急诊冠状动脉介入诊疗术（CAG或PCI）术前胱抑素C（CysC）与氨基末端脑钠肽前体（NT-proBNP）水平与术后发生造影剂急性肾功能损害（CI-AKI）的相关性及其对CI-AKI的预测价值。方法回顾性分析2014年5月—2014年10月在该院心内科就诊并行非急诊冠状动脉介入诊疗术的患者85例，根据术前CysC水平将CysC＜0．80 mg·L－1为C1组48例，CysC≥0．80 mg·L－1为C2组37例。结果（1）两组发病率的比较差异具有统计学意义（P＜0．05），两组间CysC、NT-proBNP、术前肌酐（Scr）及术后Scr、肾小球滤过率（c-aGFR）的水平有统计学差异（P＜0．05）；（2）Pearson相关分析显示，CysC、NT-proBNP与术后Scr呈正相关（P＜0．05）；（3）多因素 Logistic 回归分析显示，CysC 是发生 CI-AKI 的独立危险因素（P＜0．05），NT-proBNP不是发生CI-AKI的独立危险因素（P＞0．05）；（4）ROC曲线显示，CysC曲线下面积为0．697，最佳阈值为0．80 mg·L－1，敏感度为0．79，特异度为0．63，NT-proBNP曲线下面积为：0．539，最佳阈值为50．0 ng·L－1时，敏感度为0．93，特异度为0．35。结论非急诊冠状动脉介入诊疗术前CysC水平与术后发生CI-AKI有相关性，并对术后发生CI-AKI有一定的预测价值。NT-proBNP水平与术后发生CI-AKI无相关性，对术后发生CI-AKI的预测价值不显著。
목적：탐토비급진관상동맥개입진료술（CAG혹PCI）술전광억소C（CysC）여안기말단뇌납태전체（NT-proBNP）수평여술후발생조영제급성신공능손해（CI-AKI）적상관성급기대CI-AKI적예측개치。방법회고성분석2014년5월—2014년10월재해원심내과취진병행비급진관상동맥개입진료술적환자85례，근거술전CysC수평장CysC＜0．80 mg·L－1위C1조48례，CysC≥0．80 mg·L－1위C2조37례。결과（1）량조발병솔적비교차이구유통계학의의（P＜0．05），량조간CysC、NT-proBNP、술전기항（Scr）급술후Scr、신소구려과솔（c-aGFR）적수평유통계학차이（P＜0．05）；（2）Pearson상관분석현시，CysC、NT-proBNP여술후Scr정정상관（P＜0．05）；（3）다인소 Logistic 회귀분석현시，CysC 시발생 CI-AKI 적독립위험인소（P＜0．05），NT-proBNP불시발생CI-AKI적독립위험인소（P＞0．05）；（4）ROC곡선현시，CysC곡선하면적위0．697，최가역치위0．80 mg·L－1，민감도위0．79，특이도위0．63，NT-proBNP곡선하면적위：0．539，최가역치위50．0 ng·L－1시，민감도위0．93，특이도위0．35。결론비급진관상동맥개입진료술전CysC수평여술후발생CI-AKI유상관성，병대술후발생CI-AKI유일정적예측개치。NT-proBNP수평여술후발생CI-AKI무상관성，대술후발생CI-AKI적예측개치불현저。
Objective To explore the correlation between cystatin c (CysC),n-terminal probrain natriuretic peptide (NT-proBNP)and contrast-induced acute kidney injury (CI-AKI)after non-urgent coronary arteriography (CAG)or percutaneous coronary interventions (PCI).Methods We retrospectively analyzed 85 patients admitted to our hospital from May 2014 to November 2014 with non-urgent CAG or PCI.Patients were divided into C1 group (CysC<0.80 mg·L-1 ,n=48)and C2 group (CysC≥0.80 mg·L-1 ,n=37).Re-sults (1)The C2 group has higher incidence of CI-AKI than the C1 group (P <0.05).(2)Pearson correlation analysis indicated that postoperative Scr was positively correlated with CysC and NT-proBNP (P <0.05).(3)Multivariate analysis showed that CysC was the independent risk factor of CI-AKI (P <0.05),but not for NT-proBNP (P>0.05).(4)Receiver operating characteristic (ROC)curve analysis revealed that the optimal cutoff of CysC to predict CI-AKI is 0.80 mg·L-1 (AUC =0.697,sensitivity 0.79, specificity 0.63),and the optimal cutoff of NT-proBNP to predict CI-AKI is 50.0 ng·L-1 (AUC=0.539,sensitivity 0.93,specificity 0.35).Conclusions CysC is positively correlated with CI-AKI incidence,and is also the independent risk predictor of CI-AKI after non-urgent CAG or PCI,but not for NT-proBNP.