甘油三酯-葡萄糖指数与急性心肌梗死经皮冠状动脉介入术后造影剂肾病的关系

Relationship between triglyceride-glucose index and contrast-induced nephropathy after PCI in patients with acute myocardial infarction

目的:探讨甘油三酯-葡萄糖(TyG)指数与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后发生造影剂肾病(CIN)的相关性。方法:对2017年1月—2022年5月于福建医科大学附属闽东医院接受PCI的308例AMI患者进行回顾性分析,观察患者的临床特点,计算TyG指数,记录术前和术后3 d内的血肌酐水平及其他生化指标、临床用药及超声心动图结果。根据PCI术后是否发生CIN,将患者分为CIN组(38例)和非CIN组(270例)。比较两组患者临床资料的差异,采用单因素和多因素logistic回归分析筛选CIN的独立危险因素,采用受试者工作特征曲线(ROC)评估TyG指数对CIN的预测价值。结果:多因素logistic回归分析显示,年龄(OR=1.049,95%CI:1.001~1.100,P=0.046)和TyG指数(OR=3.929,95%CI:1.553~9.939,P=0.004)为AMI患者PCI术后CIN的独立危险因素,血红蛋白(OR=0.95,95%CI:0.925~0.975,P<0.01)为保护性因素。TyG指数预测AMI患者PCI术后发生CIN的曲线下面积(AUC)为0.652(95%CI:0.554~0.750,P=0.002)。结论:TyG指数可作为有效识别AMI患者PCI术后发生CIN的早期生物标志物,且CIN发生率随TyG水平的增高而升高。

Objective:To investigate the relationship between triglyceride-glucose(TyG) index and contrast-induced nephropathy(CIN) after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI).Methods:A retrospective analysis was performed on 308 AMI patients who underwent PCI from January 2017 to May 2022 in Mindong Hospital Affiliated to Fujian Medical University.Clinical characteristics of patients were observed and the TyG index was calculated.Serum creatinine level and other biochemical indexes,clinical medication and cardiac color ultrasound results were recorded before and 3 days after PCI.According to whether CIN occurred after PCI,patients were divided into the CIN group(n=38) and non-CIN group(n=270).Clinical data between the two groups were compared,univariate and multivariate logistic regression analysis was used to explore independent risk factors of CIN,and receiver operating characteristic curve(ROC) was used to evaluate the predictive value of the TyG index for predicting CIN.Results:Multivariate logistic regression analysis showed that TyG index(OR=3.929,95%CI:1.553-9.939,P=0.004) and age(OR=1.049,95%CI:1.001-1.100,P=0.046) were independent risk factors for CIN after PCI in AMI patients,while hemoglobin(OR=0.95,95%CI:0.925-0.975,P<0.01) was a protective factor.The area under the curve(AUC) that TyG index predicted CIN in AMI patients after PCI was 0.652(95%CI:0.554-0.750,P=0.002).Conclusion:TyG index is an effective early biomarker to identify CIN after PCI in AMI patients,and the incidence of CIN increases with the increase of TyG level.