肿瘤坏死因子样凋亡微弱诱导剂水平和造影剂肾病的相关性

Correlation of tumor necrosis factor-like weak inducer of apoptosis and contrast-induced nephropathy

目的探讨肿瘤坏死因子样凋亡微弱诱导剂（TWEAK）水平和造影剂肾病（CIN）的相关性。方法行冠状动脉（冠脉）造影的慢性肾功能不全患者400例,根据血清TWEAK检测结果分为A组（TWEAK〈450pg/ml,134例）、B组（450pg/ml≤TWEAK〈550pg/ml,133例）和C组（TWEAK≥550pg/ml,133例）,比较三组的CIN发生率。结果 400例患者术后发生CIN患者共53例（13.3%）,其TWEAK水平高于未发生CIN患者（P〈0.05）。B组住院期间CIN发生率高于A组、低于C组（13.5%vs.8.2%、18.0%）（P〈0.05）。校正年龄、左心室射血分数、糖尿病、肾小球滤过率等因素后,与A组比较,C组冠脉造影后发生CIN的风险显著增加（OR=1.45,95%CI：1.12-2.64,P〈0.01）。结论冠脉造影患者的TWEAK水平和CIN发生率显著相关,高TWEAK水平可能增加冠脉造影后CIN发生率。

Objective To investigate the correlation of tumor necrosis factor-like weak inducer of apoptosis（TWEAK）and contrast-induced nephropathy（CIN）.Methods A total of 400 patients with chronic renal failure undergoing coronary angiography（CAG）was divided into three groups of A（TWEAK〈450pg/ml,134cases）,B（450pg/ml≤TWEAK〈550pg/ml,133cases）and C（TWEAK≥550pg/ml,133cases）.The incidence of CIN was compared among three groups.Results The incidence of CIN was 13.3%in 400 patients.The TWEAK level of the patients with CIN was higher than that in those without CIN（P〈0.05）.The incidence of CIN in group B was higher than that in group A and lower than that in group C（13.5% vs.8.2% and 18.0%）（P〈0.05）.After adjusted for age,left ventricular ejection fraction,diabetes mellitus,estimated glomerular filtration rate,the risk of postoperative CIN was significantly higher in group C than that in group A（OR=1.45,95%CI：1.12-2.64,P〈0.01）.Conclusion Serum level of TWEAK is closely correlated with the incidence of CIN in the patients undergoing CAG.A higher level of serum TWEAK before operation may increase the risk for CIN after CAG.