尿KIM-1、TIMP-2和sTREM-1对老年患者经皮冠状动脉介入治疗后造影剂所致急性肾损伤的预测价值。

IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of General Medicine Pub Date : 2025-01-11 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S495766
Wu Huang, Rong Wang, Ping Zhang
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引用次数: 0

摘要

目的:探讨尿肾损伤分子-1 (KIM-1)、金属蛋白酶组织抑制剂-2 (TIMP-2)和骨髓细胞可溶性触发受体-1 (sTREM-1)对老年患者经皮冠状动脉介入治疗(PCI)后造影剂诱导的急性肾损伤(CI-AKI)的预测价值。方法:将136例PCI患者根据术后CI-AKI发生率分为CI-AKI组(n = 36)和非CI-AKI组(n = 100),收集其一般资料。术前(入院时)、术后6 h、12 h、24 h、48 h采集血、尿标本保存备用。检测血清肌酐(Scr)水平并计算估计的肾小球滤过率(eGFR)。评估尿KIM-1、TIMP-2、sTREM-1水平,比较术前、一般资料及术后尿KIM-1、TIMP-2、sTREM-1水平。采用受试者工作特征(ROC)曲线分析术后6 h尿KIM-1、TIMP-2、sTREM-1对CI-AKI的早期诊断价值。结果:术后48 h, CI-AKI组Scr高于非CI-AKI组。术后24 h和48 h, CI-AKI组eGFR低于非CI-AKI组;CI-AKI组尿KIM-1和sTREM-1高于非CI-AKI组;TIMP-2在CI-AKI组高于非CI-AKI组。ROC曲线分析显示,术后6 h尿液KIM-1、TIMP-2、sTREM-1诊断CI- aki的曲线下面积(auc)分别为0.852 (95% CI: 0.768 ~ 0.936)、0.810 (95% CI: 0.723 ~ 0.898)、0.874 (95% CI: 0.804 ~ 0.943),临界值分别为45.93 ng/L、1.63 ng/mL、61.48 ng/L,敏感性分别为66.70%、58.30%、72.20%,特异性分别为95.00%、93.00%、91.00%,差异均有统计学意义(P < 0.05)。结论:尿KIM-1、TIMP-2、sTREM-1可响应PCI术后早期肾功能变化,在CI-AKI早期诊断中具有较好的应用价值。
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Predictive Value of Urinary KIM-1, TIMP-2 and sTREM-1 for Contrast-Induced Acute Kidney Injury in Elderly Patients After Percutaneous Coronary Intervention.

Objective: We aimed to address the predictive value of urinary kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinases-2 (TIMP-2) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for contrast-induced acute kidney injury (CI-AKI) in elderly patients after percutaneous coronary intervention (PCI).

Methods: One hundred thirty-six patients who underwent PCI were separated into the CI-AKI group (n = 36) and the non-CI-AKI group (n = 100) based on CI-AKI occurrence after operation, and their general data were collected. Blood and urine specimens were collected before operation (at the time of admission) and 6 h, 12 h, 24 h and 48 h after the operation and preserved for future use. Serum creatinine (Scr) levels were tested and an estimated glomerular filtration rate (eGFR) was counted. Urinary KIM-1, TIMP-2 and sTREM-1 levels were assessed and the preoperative and general data as well as postoperative urinary KIM-1, TIMP-2 and sTREM-1 levels were compared. The early diagnostic value of urinary KIM-1, TIMP-2 and sTREM-1 at 6 hours postoperatively for CI-AKI was analyzed by receiver operating characteristic (ROC) curve.

Results: After 48 h of operation, Scr in the CI-AKI group was higher versus the non-CI-AKI group. At 24 h and 48 h postoperatively, eGFR in the CI-AKI group was lower versus the non-CI-AKI group; urinary KIM-1 and sTREM-1 in the CI-AKI group were higher in contrast to the non-CI-AKI group; TIMP-2 in the CI-AKI group was higher versus that in the non-CI-AKI group. ROC curve analysis showed that the areas under the curve (AUCs) for urine KIM-1, TIMP-2, and sTREM-1 in diagnosing CI-AKI at 6 hours postoperatively were 0.852 (95% CI: 0.768-0.936), 0.810 (95% CI: 0.723-0.898), and 0.874 (95% CI: 0.804-0.943), and the cut-off values were 45.93 ng/L, 1.63 ng/mL, and 61.48 ng/L, respectively, with sensitivities of 66.70%, 58.30%, and 72.20%, and specificities of 95.00%, 93.00%, and 91.00%, respectively (all P < 0.05).

Conclusion: Urinary KIM-1, TIMP-2 and sTREM-1 can respond to early changes in renal function after PCI and have good application value in the early diagnosis of CI-AKI.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
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发文量
1113
审稿时长
16 weeks
期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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