高敏C反应蛋白与介入诊疗术后对比剂肾病相关性的Meta分析

Correlation between high sensitivity C reactive protein and contrast-induced nephropathy after interventional therapy:a Meta analysis

目的系统评价高敏C反应蛋白(hs-CRP)与患者行冠状动脉造影(CAG)或经皮冠状动脉介入治疗(PCI)术后发生对比剂肾病(CIN)的相关性。方法检索PubMed、Web of Science、中国生物医学文献数据库、中国知网、万方数据等数据库,选取从建库到2021年3月7日发表的CIN组和非CIN组CAG或PCI患者术前hs-CRP水平的研究。获得相关数据后,使用RevMan 5.3和Stata 12.0软件进行Meta分析。结果最终纳入了14项相关研究,包括11885例CAG或PCI治疗患者(1034例CIN患者和10851例非CIN患者)。Meta分析结果显示,CIN组hs-CRP水平显著高于非CIN组(WMD=3.77,95%CI:2.80~4.74,P<0.001,I2=93%),CAG或PCI术前hs-CRP水平较高的患者更容易发生CIN。敏感性分析表明该研究的结果具有较好的稳定性,亚组分析的结果表明样本量、研究人群、地理位置和CIN的定义的差异具有统计学意义。结论现有证据显示,高hs-CRP水平是CAG或PCI术后CIN的危险因素,然而仍需要大样本试验来支持这一结论。

Objective To systematically evaluate the correlation of high sensitivity C-reactive protein(hs-CRP)with contrast-induced nephropathy(CIN)in patients following coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods PubMed,web of science,CBM,CNKI and Wanfang Data were searched for studies on hs-CRP levels in patients undergoing CAG or PCI patients from the incipience of the database to March 7,2021.Meta-analysis was performed by RevMan 5.3 and Stata 12.0 software.Results Fourteen related studies were included involving 11885 patients undergoing CAG or PCI(1034 cases with CIN and 10851 cases without CIN).The results of meta-analysis showed that the level of hs-CRP in CIN group was significantly higher than that in non-CIN group(WMD=3.77,95%CI:2.80—4.74,P<0.001,I²=93%),patients with higher levels of hs-CRP before CAG or PCI were more likely to develop CIN.Sensitivity analysis shows that the results of this study had good stability.The results of subgroup analysis show that the differences in sample size,study population,geographical location and the definition of CIN were statistically significant.Conclusion Available evidence shows that high hs-CRP level is a risk factor for CIN in patients undergoing CAG or PCI,large sample trials are still needed to support this conclusion.