[1]高 珍,覃 辉.经皮冠状动脉介入术后造影剂诱导急性肾损伤预测模型的构建[J].医学信息,2021,34(16):87-90.[doi:10.3969/j.issn.1006-1959.2021.16.023]
　GAO Zhen,QIN Hui.Construction of A Predictive Model of Contrast Agent-induced Acute Kidney Injury After Percutaneous Coronary Intervention[J].Medical Information,2021,34(16):87-90.[doi:10.3969/j.issn.1006-1959.2021.16.023]
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经皮冠状动脉介入术后造影剂诱导急性肾损伤预测模型的构建()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年16期
页码:
87-90
栏目:
论著
出版日期:
2021-08-15

文章信息/Info

Title:
Construction of A Predictive Model of Contrast Agent-induced Acute Kidney Injury After Percutaneous Coronary Intervention
文章编号:
1006-1959（2021）16-0087-04
作者:
高 珍; 覃 辉
（1.武昌理工学院健康与护理学院，湖北 武汉 430223； 2.武汉市中心医院护理部，湖北 武汉 430014）
Author(s):
GAO Zhen; QIN Hui
(1.School of Health and Nursing,Wuchang University of Technology,Wuhan 430223,Hubei,China; 2.Nursing Department,the Central Hospital of Wuhan,Wuhan 430014,Hubei,China)
关键词:
急性肾损伤; 经皮冠状动脉介入术; 预测模型
Keywords:
Acute kidney injury; Percutaneous coronary intervention; Prediction model
分类号:
R541
DOI:
10.3969/j.issn.1006-1959.2021.16.023
文献标志码:
A
摘要:
目的 建立经皮冠状动脉介入（PCI）术后造影剂诱导急性肾损伤（CI-AKI）的风险预测模型。方法 回顾性分析2019年1月~2020年12月某三甲医院800例行PCI术患者的临床资料，根据是否发生CI-AKI分为CI-AKI组和非CI-AKI组，比较两组临床资料，采用二项Logistic回归分析CI-AKI的危险因素，ROC曲线判断模型的预测效能。结果 共800例PCI患者，其中52例患者发生CI-AKI，发生率为6.50%。两组年龄、糖尿病、脑血管病史，心功能不全、周围血管病变、术中低血压、慢性肾病、术前肌酐、BNP、术前CRP、血红蛋白、手术时间比较，差异有统计学意义（P＜0.05）；两组性别、高血压、既往AKI、贫血、高尿酸、高脂血症、心肌梗塞史、造影剂剂量、术后低血压比较，差异无统计学意义（P＞0.05）。二项Logistic回归分析显示，年龄＞75岁、糖尿病、慢性肾病、脑血管病史、术前BNP≥88.7 pg/ml、术前CRP＞9 mg/L是PCI术后CI-AKI的危险因素。ROC曲线分析显示，模型ROC曲线下面积为0.826（95%CI：0.807~0.845，P＜0.001），Hosmer-Lemeshow检验显示模型拟合优度较好，回归方程预测准确率为83.00%。结论 CI-AKI是冠状动脉内支架置入术后常见的并发症，与预后不良有关。年龄＞75岁、糖尿病、慢性肾病、脑血管病史、术前BNP≥88.7 pg/ml、术前CRP＞9 mg/L是AKI的危险因素。本研究得出的模型是一种简单、可靠的预测PCI术后CI-AKI风险的工具，可用于监测患者护理风险分层。
Abstract:
Objective To establish a CI-AKI risk prediction model for patients after percutaneous coronary intervention (PCI).Methods A retrospective analysis of the clinical data of 800 patients undergoing PCI in a tertiary hospital from January 2019 to December 2020.According to whether CI-AKI occurred, it was divided into CI-AKI group and non-CI-AKI group. The clinical data of the two groups were compared, the risk factors of CI-AKI were analyzed by binomial Logistic regression, and the ROC curve was used to judge the predictive power of the model.Results A total of 800 PCI patients, of which 52 patients developed CI-AKI, the incidence rate was 6.50%.The two groups of age, diabetes, history of cerebrovascular disease, cardiac insufficiency, peripheral vascular disease, intraoperative hypotension, chronic kidney disease, preoperative creatinine, BNP, preoperative CRP, hemoglobin, and operation time, the difference was statistically significant (P<0.05);There was no significant difference between the two groups in gender, hypertension, previous AKI, anemia, hyperuric acid, hyperlipidemia, history of myocardial infarction, dose of contrast agent, and postoperative hypotension (P>0.05).Logistic regression analysis showed that age>75 years, diabetes, chronic kidney disease, history of cerebrovascular disease, preoperative BNP≥88.7 pg/ml, preoperative CRP>9 mg/L were risk factors for CI-AKI after PCI.ROC curve analysis showed that the area under the model ROC curve was 0.826 (95%CI: 0.807-0.845, P＜0.001),the Hosmer-Lemeshow test showed that the goodness of fit of the model was good, and the prediction accuracy of the regression equation was 83.00.Conclusion CI-AKI is a common complication after coronary stenting and is related to poor prognosis.Age>75 years, diabetes, chronic kidney disease, history of cerebrovascular disease, preoperative BNP≥88.7 pg/ml, preoperative CRP>9 mg/L are risk factors for AKI.The model obtained in this study is a simple and reliable tool for predicting the risk of CI-AKI after PCI, and can be used to monitor patient care risk stratification.

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更新日期/Last Update: 1900-01-01