叶飘,谭宁,陈纪言,刘勇,刘远辉,李华龙,蒋磊

• 1:广东省心血管病研究所 广东省人民医院 广东省医学科学院

摘要(Abstract)：

目的探讨中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与急性ST段抬高心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)术后发生对比剂肾病(contrastinduced nephropathy,CIN)的相关性。方法入选500例行急诊PCI的患者,CIN定义为使用对比剂后48~72 h内血肌酸酐(肌酐)值较基线值升高超过44.2μmol/L或者较原基础值升高25%以上。比较CIN组与非CIN组之间的基线资料及院内不良临床事件发生率。采用受试者工作特征(ROC)曲线及Logistics回归分析评估NLR与CIN风险的相关性。结果 500例患者中,85例(17%)患者发生CIN。CIN组在院内死亡、需要肾脏替代治疗、需使用主动脉内球囊反搏、围术期低血压、急性心力衰竭、新发心律失常等院内不良事件的发生率均较非CIN组明显升高,差异有统计学意义。ROC曲线显示:NLR界值为6.03时,其预测CIN的敏感度为80.1%,特异度为73.7%,曲线下面积0.764。单因素Logistics回归分析显示,NLR水平与CIN发病率明显相关(OR 1.2,95%CI 1.1~1.3,P<0.01)。多因素Logistic回归分析显示,NLR>6.03是CIN的独立危险因素(OR 1.3,95%CI1.2~1.3,P<0.001);此外,女性、基础肾功能不全及围术期低血压也是CIN的独立危险因素(P<0.05)。结论急性STEMI患者行急诊PCI术前NLR水平与CIN相关,NLR升高的患者发生CIN的风险明显增高。

关键词(KeyWords)： 中性粒细胞/淋巴细胞比值;对比剂;肾病;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81270286)

作者(Author): 叶飘,谭宁,陈纪言,刘勇,刘远辉,李华龙,蒋磊

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