单核细胞/高密度脂蛋白胆固醇比值不能预测PCI术后对比剂肾病的发生

Monocyte to high-density lipoprotein cholesterol ratio can not predict contrast induced nephropathy in patients after PCI

目的探讨术前单核细胞与高密度脂蛋白比值(monocyte to high-density lipoprotein cholesterol ratio,MHR)与经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后发生造影剂肾病(contrast-induced nephropathy,CIN)的相关性,为CIN的发生寻找其他可能的危险因素,为及早筛选CIN高危人群提供新的方向。方法回顾性分析5P试验入选的我院心内一科行经皮冠状动脉介入治疗术的冠心病患者1087例,根据在PCI术后是否发生造影剂肾病分为CIN组和非CIN组,研究CIN的相关危险因素,分析MHR与造影剂肾病的相关性,应用Logistic回归分析查看MHR是否为CIN发病的高危因素。结果CIN组共57例,非CIN组1030例。两组在高脂血症、BMI、左心室射血分数(LVEF)、术前尿酸及术前C-反应蛋白水平等方面比较差异有统计学意义(P<0.05)。Logistic回归分析显示LVEF及糖尿病与造影剂肾病的发生相关。结论同以往研究结果不同,MHR并不能作为CIN的危险因素,但LVEF对于CIN可能具有更高的预测价值。

Objective To investigate the correlation between preoperative monocytes to high-density lipoprotein cholesterol ratio(MHR)and contrast induced nephropathy(CIN)after percutaneous coronary intervention(PCI),to find other possible risk factors for the occurrence of CIN,and to provide a new direction for screening CIN in high-risk groups as early as possible.Methods Retrospective analysis was made on 1087 patients with coronary heart disease who were selected by 5P test and underwent PCI in the department of cardiology of our hospital.They were divided into CIN group and non-CIN group according to whether there was CIN after PCI.The related risk factors of CIN and the correlation between MHR and CIN were studied.Logistic regression analysis was applied to see whether MHR was a risk factor for CIN.Results There were 57 patients in CIN group and 1030 patients in non-CIN group.There were statistically significant differences in hyperlipidemia,BMI,left ventricular ejection fraction(LVEF),preoperative uric acid and preoperative C-reactive protein levels between two groups(P<0.05).Logistic regression analysis showed that LVEF and diabetes were correlated with the incidence of CIN.Conclusion Different from the previous studies,MHR can not be considered as a risk factor for CIN,but LVEF may have higher predictive value for CIN.