IL-6、Kim-1与冠心病患者PCI术后CIN的相关性研究

Correlation between IL-6 and Kim-1 and CIN after PCI for patients with coronary heart disease

目的探讨白细胞介素(interleukin,IL)-6及肾损伤分子(kidney injury molecule,Kim)-1对冠心病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后对比剂肾病(contrast-induced pnephropathy,CIN)的早期预测价值。方法回顾性分析730例行PCI术的冠心病患者资料,分为CIN组(n=46)和非CIN组(n=684),比较两组患者的病历资料,二元回归分析术后Kim-1、IL-6与CIN的关系,通过受试者操作特征(receiver operating characteristic,ROC)曲线,探讨两种标志物对冠心病PCI术后CIN的预测价值。结果两组患者术前IL-6(P=0.467)与Kim-1(P=0.643)差异均无统计学意义,PCI术后48h及72h时,CIN组患者的IL-6与Kim-1均高于非CIN组(P<0.001),CIN组患者的IL-6与Kim-1均较术前升高(P<0.001)。术后48h IL-6(OR=1.884,P=0.002)和Kim-1(OR=1.409,P<0.001)、术后72h IL-6(OR=1.377,P<0.001)和Kim-1(OR=1.092,P=0.004)均为CIN的独立危险因素。ROC曲线结果显示,在作为CIN的诊断标志物时,术后48h、术后72h IL-6曲线下面积(area under the curve,AUC)分别为0.837、0.782,术后48h、术后72h Kim-1 AUC为0.820、0.827。结论IL-6、Kim-1是冠心病患者PCI术后发生CIN的独立危险因素。IL-6和Kim-1与冠心病患者PCI术后CIN的发生呈正相关。IL-6和Kim-1对冠心病PCI术后CIN的诊断敏感度和特异性均较好,且具有一定的预测价值。

Objective To investigate the value of interleukin(IL)-6 and kidney injury molecule(Kim)-1 in the early prediction of contrast-induced pnephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods A total of 730 patients with coronary heart disease who underwent PCI were retrospectively collected,divided into CIN group(n=46)and non-CIN group(n=684),and the medical records of the two groups were compared,and the relationship between Kim-1 and IL-6 of renal injury and CIN was analyzed by binary regression,and the receiver operating characteristic(ROC)curve was used to explore the predictive value of these two markers on CIN after PCI for coronary heart disease.Results There was no significant difference between two groups in terms of preoperative IL-6(P=0.467)and Kim-1(P=0.643),and 48h and 72h after PCI,IL-6 and Kim-1 in CIN group was higher than that in non-CIN group(P<0.001),and IL-6 and Kim-1 in CIN group was higher than that in before surgery(P<0.001).48h postoperative IL-6(OR=1.884,P=0.002),48h postoperative Kim-1(OR=1.409,P<0.001)and 72h postoperative IL-6(OR=1.377,P<0.001)and 72 hours postoperative Kim-1(OR=1.092,P=0.004)were independent risk factors for CIN.The ROC curve showed that when used as a diagnostic marker for CIN,the area under the curve(AUC)of IL-6(48h),IL-6(72h)were 0.837,0.782,AUC of 48h Kim-1 and 72h Kim-1 were 0.820 and 0.827,respectively.Conclusion IL-6 and Kim-1 are independent risk factors for CIN after PCI for coronary heart disease.IL-6 and Kim-1 were positively correlated with the occurrence of CIN after PCI for coronary heart disease.IL-6 and Kim-1 have good diagnostic sensitivity and specificity for CIN after PCI for coronary heart disease.