血红蛋白与左室射血分数乘积对急性非ST段抬高型心肌梗死患者经皮冠状动脉介入术后对比剂肾病预测价值研究

Predictive value of combination of hemoglobin and left ventricular ejection fraction for contrast-induced nephropathy in patients with non-ST elevation myocardial infarction

目的评估血红蛋白与左室射血分数乘积（Hb×EF）对急性非ST段抬高型心肌梗死（non—STelevationmyocardialinfarction，NSTEMI）患者经皮冠状动脉介入（PCI）术后对比剂肾病（contrast—inducednephropathyCIN）的预测价值。方法于2013—05—01—2014-03—26连续入选马鞍山市中心医院NSTEMI患者225例，计算所有患者血红蛋白与左室射血分数的乘积以及估算的肾小球滤过率（eGFR）值，采用Lo小tic回归分析影响PCI术后CIN的危险因素，ROC曲线分析评估血红蛋白与左室射血分数乘积对对比剂肾病的预测价值。结果所有入选患者PCI术后CIN发生率为9．8％。HbxEF是NSTEMI患者PCI术后独立危险因素（OR0．995，95％C10．993—0．997，P=0．0011。ROC曲线分析显示，当Hb×EF〈620预测CIN的敏感度与特异度分别为83％和54％，Hb×EF〉620时CIN的阴性预测价值95．0％。结论血红蛋白与左室射血分数乘积作为一个新的参数，能很好地预测急性非ST段抬高型心肌梗死患者PCI术后CIN的发生。

Objective To evaluate the value of the combination of hemoglobin and left ventricular ejection fraction （HbxEF） for predicting the development of contrast-induced nephropathy （CIN） in patients with non-ST devation myocardial infarction undergoing percutaneous coronary intervention （PCI）. Methods A total of 225 consecutive patients were included in this study from May 1, 2013 to March 26, 2014. We calculated their HbxEF and estimated the glomerular filtration rates. The risk of CIN was assessed using logistic regression analysis. The ROC curve analysis was used to detect the best predictive value of HbxEF. Results Contrast-induced nephropathy was observed in 22 （9.8%） of the patients. HbxEF was found to be the independent predictor for CIN （OR 0.995, 95%CI 0.993-0.997, P -- 0.001）. HbxEF 〈620 had a sensitivity of 83% and a specificity of 54% for prediction of CIN. In addition, HbxEF〈620 had a negative predictive value of 95.0% in our analysis. Conclusion As a new parameter, HbxEFis better at predicting CIN in PCI patients with non-ST elevation myocardial infarction.