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目的评估血红蛋白与左室射血分数乘积(Hb×EF)对急性非ST段抬高型心肌梗死(non-ST elevation myocardial infarction,NSTEMI)患者经皮冠状动脉介入(PCI)术后对比剂肾病(contrast-induced nephropathy CIN)的预测价值。方法于2013-05-01—2014-03-26连续入选马鞍山市中心医院NSTEMI患者225例,计算所有患者血红蛋白与左室射血分数的乘积以及估算的肾小球滤过率(e GFR)值,采用Logistic回归分析影响PCI术后CIN的危险因素,ROC曲线分析评估血红蛋白与左室射血分数乘积对对比剂肾病的预测价值。结果所有入选患者PCI术后CIN发生率为9.8%。Hb×EF是NSTEMI患者PCI术后独立危险因素(OR 0.995,95%CI 0.993~0.997,P=0.001)。ROC曲线分析显示,当Hb×EF<620预测CIN的敏感度与特异度分别为83%和54%,Hb×EF>620时CIN的阴性预测价值95.0%。结论血红蛋白与左室射血分数乘积作为一个新的参数,能很好地预测急性非ST段抬高型心肌梗死患者PCI术后CIN的发生。
Objective To evaluate the relationship between hemoglobin and left ventricular ejection fraction (Hb × EF) in patients with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) contrast-induced nephropathy CIN). Methods Totally 225 patients with NSTEMI in Central Hospital of Ma’anshan were enrolled on 2013-05-01-2014-03-26. The product of hemoglobin and left ventricular ejection fraction and the estimated glomerular filtration rate (e GFR) of all patients were calculated Logistic regression analysis was used to analyze the risk factors of CIN after PCI. ROC curve analysis was used to evaluate the predictive value of product of hemoglobin and left ventricular ejection fraction in contrast agent nephropathy. Results The incidence of CIN after PCI in all the patients was 9.8%. Hb × EF was an independent risk factor for postoperative PCI in patients with NSTEMI (OR 0.995, 95% CI 0.993-0.997, P = 0.001). ROC curve analysis showed that the sensitivity and specificity of CIN were 83% and 54% when Hb × EF <620, respectively. The negative predictive value of CIN was 95.0% when Hb × EF> 620. Conclusion The product of hemoglobin and left ventricular ejection fraction is a new parameter that can predict the occurrence of CIN after PCI in patients with acute non-ST-segment elevation myocardial infarction.