外周血GPR120水平与eGFR关系及预测冠状动脉造影术后CI-AKI的价值

The relationship between peripheral blood GPR120 levels and eGFR and the value of predicting CIAKI after coronary angiography

目的探讨G蛋白偶联受体120(GPR120)水平与行冠状动脉(冠脉)造影术患者估算的肾小球滤过率(eGFR)的关系,并评估GPR120对术后对比剂急性肾损伤(CI-AKI)的预测价值。方法选取2020年1月至2023年1月于攀枝花市中心医院行冠脉造影患者293例为研究对象,其中发生CI-AKI 32例(观察组);未发生CI-AKI261例(对照组)。两组均于术前检测外周血白细胞中GPR120 mRNA、eGFR水平。通过电子病历系统收集入选患者资料,根据最邻近匹配法对两组患者进行1:1匹配,Logistic回归模型计算评分值。分析GPR120 mRNA与eGFR的相关性,采用Logisitic回归模型分析GPR120 mRNA与冠脉造影术后CI-AKI的独立关系,绘制受试者工作曲线(ROC)评估GPR120 mRNA预测冠脉造影术后CI-AKI的价值。结果倾向性评分匹配后观察组左室射血分数、基线eGFR、基线eGFR<60 ml/(min·1.73 m^(2))比例、GPR120 mRNA低于对照组,造影剂用量大于对照组,造影剂接触时间长于对照组(P<0.05);GPR120 mRNA与基线eGFR呈正相关(r=0.707,95%CI:0.559~0.812,P<0.001);随着GPR120 mRNA水平升高,患者冠脉造影术后CI-AKI发生率呈降低趋势(P<0.05);调整混杂因素后GPR120 mRNA表达上调仍可降低冠脉造影术后CI-AKI发生风险(P<0.05);GPR120 mRNA对冠脉造影术后CI-AKI的AUC值为0.774,对应敏感度、特异度分别为65.62%、84.37%。结论行冠脉造影术的患者GPR120水平与基线eGFR呈正相关,可作为预测术后CI-AKI的指标之一。

Objective To investigate the relationship between G-protein-coupled receptor 120(GPR120)levels and estimated glomerular filtration rate(eGFR)in patients undergoing coronary angiography,and to evaluate the value of GPR120 in predicting postoperative contrast acute kidney injury(CI-AKI).Methods A total of 293 patients who underwent coronary angiography at the Central Hospital of Panzhihua City from January 2020 to January 2023 were selected as the study subjects,among which 32 patients developed CI-AKI and were included in the observation group.Two hundred sixty-one cases without CI-AKI were included in the control group.The levels of GPR120 mRNA and eGFR in peripheral blood leukocytes of both groups were detected before surgery.The data of enrolled patients were collected by electronic medical record system,and 1:1 matching was performed between the two groups of patients according to the nearest matching method,and the score was calculated by Logistic regression model.The correlation between GPR120 mRNA and eGFR was analyzed.Logisitic regression model was used to analyze the independent relationship between GPR120 mRNA and CI-AKI after coronary angiography.Receiver operating curve(ROC)was plotted to evaluate the value of GPR120 mRNA in predicting CI-AKI after coronary angiography.Results After matching by propensity score,left ventricular ejection fraction,baseline eGFR,baseline eGFR<60 ml/(min·1.73 m^(2))ratio and GPR120 mRNA in observation group were lower than those in control group,contrast agent dosage was higher than that in control group,and contrast agent contact time was longer than that in control group(P<0.05).GPR120 mRNA was positively correlated with baseline eGFR(r=0.707,95%CI:0.559~0.812,P<0.001).With the increase of GPR120 mRNA level,the incidence of CI-AKI showed a decreasing trend after coronary angiography(P<0.05).After adjusting for confounding factors,the up-regulated expression of GPR120 mRNA still reduced the risk of CI-AKI after coronary angiography(P<0.05).The AUC value of GPR120 mRNA for CI-AKI after coronary angiography was 0.774,and the corresponding sensitivity and specificity were 65.62%and 84.37%,respectively.Conclusion GPR120 levels in patients undergoing coronary angiography are positively correlated with baseline eGFR and it can be used as a predictor of postoperative CI-AKI.