摘要
目的:探讨糖化血红蛋白(HbA1c)对糖尿病合并冠心病患者经皮冠状动脉介入治疗(PCI)术后造影剂诱导急性肾损伤(CI-AKI)发生的预测价值。方法:纳入2017-03-2022-03黄石爱康医院收治的行PCI手术的糖尿病合并冠心病患者339例,依据PCI术后72h内肌酐水平的变化将其分为CI-AKI组(73例)和非CI-AKI组(266例)。采用AU5800型全自动生化分析仪检测血清空腹血糖(FPG)、总蛋白(TP)、白蛋白(ALB)、尿素(Urea)、肌酐(Cr)、尿酸(UA)及超敏C反应蛋白(hs-CRP)水平,使用慢性肾脏病流行病学协作(CKD-EPI)公式计算估算肾小球滤过率(eGFR);普门H-9糖化血红蛋白仪检测HbA1c水平。结果:与非CI-AKI组相比,CI-AKI组HbA1c、FPG、Urea、Cr及hs-CRP水平升高,ALB、eGFR水平降低(P<0.05或P<0.01)。Logistic回归分析结果显示,HbA1c是糖尿病合冠心病PCI术发生CI-AKI的危险因素。HbA1c预测糖尿病合并冠心病患者PCI术后发生CI-AKI的受试者工作特征(ROC)曲线下面积及其95%CI为0.747(0.679-0.810)。结论:HbA1c是糖尿病合并冠心病患者PCI术后发生CI-AKI的危险因素,HbA1c水平可用于预测CI-AKI的发生。
Objective:To investigate the diagnostic value of glycosylated hemoglobin(HbA1c)in the occurrence of contrast-induced acute kidney injury(CI-AKI)in patients with diabetes and coronary heart disease after percutaneous coronary intervention(PCI).Method:From March 2017 to March 2022,339 patients with diabetes and coronary heart disease who underwent PCI were enrolled.According to the change of creatinine level within 72 hours of exposure to contrast agent(iodinated contrast agent)after PCI,they were divided into CI-AKI group(73 cases)and non-CI-AKI group(266 cases).Automatic biochemical analyzer AU5800 was used to detect serum fasting blood glucose(FPG),total protein(TP),albumin(ALB),urea(Urea),creatinine(Cr),uric acid(UA)and high-sensitivity C-reactive protein(hs-CRP)levels.Estimated glomerular filtration rate(eGFR)was calculated using the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)formula;HbA1c level was measured by glycated hemoglobin meter Pumen H-9.Results:Compared with the non-CI-AKI group,the levels of HbA1c,FPG,Urea,Cr and hs-CRP in CI-AKI group were higher,while the levels of ALB and eGFR were lower(P<0.05 or P<0.01).Logistic regression analysis showed that HbA1c was a risk factor for CI-AKI.HbA1c predicted the area under the ROC curve of CI-AKI in patients with diabetes and coronary heart disease after PCI and its 95%CI was 0.747(0.679-0.810).Conclusion:HbA1cis a risk factor for CI-AKI after PCI in patients with diabetes and coronary heart disease.HbA1clevel can be used to predict the occurrence of CI-AKI.
作者
段肖丽
向建
林雯
DUAN Xiao-li;XIANG Jian;LIN Wen(Department of Clinical Laboratory,Huangshi Aikang Hospital,Huangshi 435000,Chin)
出处
《微循环学杂志》
2023年第1期79-83,共5页
Chinese Journal of Microcirculation
关键词
造影剂诱导急性肾损伤
冠心病
糖尿病
糖化血红蛋白
Contrast-induced acute kidney injury
Coronary heart disease
Diabetes
Glycosylated hemoglobin