摘要
目的探讨平均血小板体积与淋巴细胞比率(mean platelet volume/lymphocyte ratio,MPVLR)及超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)对急性冠脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后对比剂肾病(contrast-induced nephropathy,CIN)的早期预测价值。方法回顾性收集了2020年12月—2021年12月于泰安市中心医院心内科行PCI住院治疗的495例ACS患者。完善患者入院后的相关检查,记录患者MPVLR和hs-CRP数值。根据CIN的诊断标准将患者分为CIN组和非CIN组,比较两组患者的相关检测指标有无统计学意义,分析各项指标与CIN发生的相关性,绘制诊断效能受试者工作特征(receiver operator characteristic,ROC)曲线,评估MPVLR及hs-CRP预测CIN的诊断效能。结果MPVLR和hs-CRP分组间差异有统计学意义(P<0.05),CIN的发病与MPVLR(r=0.325,P<0.001)、hs-CRP(r=0.332,P<0.001)呈正相关。ROC曲线显示,在预测CIN是否发生时,MPVLR、hs-CRP和两者联合的曲线下面积(area under curve,AUC)阈值分别为0.814、0.821、0.847,MPVLR、hs-CRP和两者联合的敏感度及特异度分别为83.7%、65.0%;67.3%、84.3%;89.8%、64.6%。结论MPVLR和hs-CRP与ACS患者PCI术后CIN的发生呈正相关;对于预测ACS患者PCI术后CIN是否发生,MPVLR和hs-CRP敏感度和特异度较好,二者结合能够起到很好的预测作用,有利于CIN的早期诊断。
Objective:To explore the early predictive value of mean platelet volume/lymphocyte ratio(MPVLR)and high sensitivity C-reactive protein(hs-CRP)in contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods:The data of 495 ACS patients who underwent PCI in the Department of Cardiology of Tai’an Central Hospital from December 2020 to December 2021 were retrospectively collected.The relevant examinations of patients after admission were made and the MPVLR and hs-CRP values of patients were recorded.According to the diagnostic criteria of CIN,the patients were divided into CIN group and non-CIN group.The patients in the two groups were compared for statistical significance.The correlation between various indicators and CIN was analyzed.The receiver operator characteristic(ROC)curve of diagnostic efficacy was drawn to evaluate the diagnostic efficacy of MPVLR and hs-CRP in predicting CIN.Results:There was significant difference between MPVLR and hs-CRP groups(P<0.05).The incidence of CIN was positively correlated with MPVLR(r=0.325,P<0.001)and hs-CRP(r=0.332,P<0.001).ROC curve showed that when predicting the occurrence of CIN,the threshold values of MPVLR,hs-CRP and their combined area under curve(AUC)were 0.814,0.821 and 0.847,the sensitivity and specificity of MPVLR,hs-CRP and their combination were 83.7%,65.0%,67.3%,84.3%and 89.8%,64.6%respectively.Conclusion:MPVLR and hs-CRP were positively correlated with the occurrence of CIN after PCI in patients with ACS.MPVLR and hs-CRP have strong sensitivity and specificity in the early diagnosis of CIN after PCI in patients with ACS.They can play a good predictive role and are conducive to the early diagnosis of CIN.
作者
李淑君
陈登攀
孙悦东
周新玲
高云
周发展
LI Shujun;CHEN Dengpan;SUN Yuedong;ZHOU Xinling;GAO Yun;ZHOU Fazhan(Department of Graduate,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Cardiology,the Affiliated Taian City Central Hospital of Qingdao University,Taian 271000,China;Department of Gastroenterology,the Affiliated Taian City Central Hospital of Qingdao University,Taian 271000,China;Department of Education Division,the Affiliated Taian City Central Hospital of Qingdao University,Taian 271000,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2022年第12期924-931,共8页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
基金
泰安市科技发展计划(2019NS115)。
