血清总胆红素对老年女性ST段抬高型心肌梗死患者介入术后造影剂肾病的预测价值

Value of serum TBIL level in predicting contrast-induced nephropathy in elderly female STEMI patients after PCI

目的探究血清总胆红素(TBIL)对老年女性ST段抬高型心肌梗死(STEMI)患者接受直接PCI后造影剂肾病(CIN)的预测价值。方法回顾性分析我院心脏内科接受直接PCI的老年女性STEMI患者579例,分为CIN组48例和非CIN组531例;收集患者一般临床资料,计算估算的肾小球滤过率(eGFR),检测TBIL水平。结果与非CIN组比较,CIN组年龄、高血压、糖尿病、肌酐、尿素、空腹血糖、白细胞计数、血小板计数明显升高,eGFR、TBIL、血红蛋白水平明显降低,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析模型结果显示,低TBIL是CIN的独立危险因素(OR=1.430,95%CI:1.217~1.834,P=0.024);年龄、糖尿病、基线肌酐、基线eGFR也均为CIN的独立危险因素(P<0.05,P<0.01)。结论低TBIL是老年女性STEMI患者PCI术后CIN的独立危险因素,TBIL可能有助于及早且准确地识别CIN高危患者,为临床治疗决策的制定提供一定的依据。

Objective To study the value of serum TBIL level in predicting contrast-induced nephropathy(CIN) in elderly female STEMI patients after PCI.Methods Five hundred and seventy-nine elderly female STEMI patients who underwent PCI in our hospital were divided into CIN group(n=48) and CIN-free group(n=531).Their general clinical data were recorded,their eGFR was calculated,and their serum TBIL level was measured.Results The age was significantly older,the incidence of hypertension and diabetes mellitus(DM),and the serum levels of creatinine,urea and fasting blood glucose were significantly higher,the number of white blood cells and platelets was significantly greater whereas the eGFR and serum levels of TBIL and hemoglobin were significantly lower in CIN group than in CIN-free group(P<0.05,P<0.01).Logistic regression analysis showed that low serum TBIL level(OR=1.430,95%CI:1.217-1.834,P=0.024),age,DM,baseline creatinine and eGFR were the independent risk factors for CIN in elderly female STEMI patients after PCI(P<0.05,P<0.01).Conclusion Low serum TBIL level is an independent risk factor for CIN in elderly female STEMI patients after PCI.TBIL can help to identify high-risk CIN patients and can thus provide certain evidence for its clinical treatment.