摘要
目的探讨全身免疫炎症指数(systemic immune inflammation index,SII)和全球急性冠状动脉事件登记(GRACE)评分与非ST段抬高型急性心肌梗死(NSTEMI)患者行经皮冠状动脉介入治疗(PCI)术后对比剂急性肾损伤(CI-AKI)发生率的关系,进一步比较SII、GRACE评分以及两者联合对CI-AKI的预测价值。方法回顾性分析2019年1月至2021年12月于徐州医科大学附属医院接受PCI的583例NSTEMI患者的临床数据。根据是否发生CI-AKI将所有患者分为CI-AKI组(n=98)和非CI-AKI组(n=485),比较两组间的基线数据。采用Logistic回归分析,分析接受PCI的NSTEMI患者发生CI-AKI的影响因素。绘制ROC曲线以评估SII、GRACE评分及其综合水平对NSTEMI患者接受PCI治疗的CI-AKI的预测价值。结果高SII、高GRACE评分的患者PCI治疗后发生CI-AKI的概率更高。多因素Logistic回归分析结果显示,平均血小板体积与淋巴细胞计数比值(MPVLR)、N末端脑钠肽前体(NT-proBNP)、SII、GRACE评分是NSTEMI患者PCI治疗后CI-AKI的独立危险因素(P<0.05)。SII与GRACE评分联合预测NSTEMI患者PCI术后CI-AKI的ROC曲线下面积为0.758(95%CI:0.713~0.802;P<0.001),敏感度为79.6%,特异度为63.2%,较单独GRACE评分(AUC=0.704,敏感度为82.7%,特异度为61.7%)、SII(AUC=0.700,敏感度为68.4%,特异度为73.8%)的曲线下面积更大,敏感性和特异度更高。结论术前较高的SII与GRACE评分对NSTEMI患者PCI治疗后发生CI-AKI具有一定预测价值,两者联合可提高NSTEMI患者PCI术后CI-AKI发生预测的准确性。
Objective To investigate the relationship among systemic immune inflammation index(SII),scores of global registry of acute coronary events(GRACE)and incidence of contrast-induced acute kidney injury(CI-AKI)in patients with non-ST-segment elevation myocardial infarction(NSTEMI)after percutaneous coronary intervention(PCI),and further compare the predictive value of SII,GRACE scores and SII combined with GRACE scores to CI-AKI.Methods The clinical data of NSTEMI patients(n=583)undergone PCI were retrospectively analyzed in Affiliated Hospital of Xuzhou Medical University from Jan.2019 to Dec.2021.All patients were divided,according whether they had CI-AKI or not,into CI-AKI group(n=98)and non-CI-AKI group(n=485).The baseline data was compared between 2 groups.The influence factors for CI-AKI were analyzed by using Logistic regression analysis in NSTEMI patients received PCI.The curve of receiver operating characteristic(ROC curve)was drawn for reviewing the predictive value of SII,GRACE scores and SII combined with GRACE scores to CIAKI.Results The incidence of CI-AKI was higher in patients with higher SII and GRACE scores after PCI.The results of multi-factor Logistic regression analysis showed that mean platelet volume to lymphocyte ratio(MPVLR),N-terminal pro-brain natriuretic peptide(NT-proBNP),SII and GRACE scores were independent risk factors of CI-AKI in NSTEMI patients after PCI(P<0.05).The area under curve(AUC)of ROC curve of SII combined with GRACE scores in predicting CI-AKI was 0.758(95%CI:0.713~0.802,P<0.001),sensitivity was 79.6%and specificity was 63.2%,which were all higher than those of single GRACE scores(AUC=0.704,sensitivity=82.7%,specificity=61.7%)and single SII(AUC=0.700,sensitivity=68.4%,specificity=73.8%).Conclusion The higher levels of preoperative SII and GRACE scores have some predictive value to CI-AKI occurrence in NSTEMI patients after PCI,and SII combined with GRACE scores can improve the accuracy of predicting the occurrence of CI-AKI.
作者
仇航
朱英华
申国旗
王珍
郑迪
陆远
李文华
Qiu Hang;Zhu Yinghua;Shen Guoqi;Wang Zhen;Zheng Di;Lu Yuan;Li Wenhua(Graduate School,Xuzhou Medical University,Xuzhou 221004,China;不详)
出处
《中国循证心血管医学杂志》
2023年第6期707-711,720,共6页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
非ST段抬高型心肌梗死
经皮冠状动脉介入治疗
对比剂急性肾损伤
全身免疫炎症指数
GRACE评分
Non-ST-segment elevation myocardial infarction
Percutaneous coronary intervention
Contrastinduced acute kidney injury
Systemic immune inflammation index
Global registry of acute coronary events scores
