血及尿DKK3在造影剂所致急性肾损伤中的预测价值-现代医学

血及尿DKK3在造影剂所致急性肾损伤中的预测价值

单位：1. 东南大学医学院, 江苏南京 210009;
2. 东南大学附属中大医院心血管内科, 江苏南京 210009

分类号：R692

出版年·卷·期（页码）：2022·50·第六期（672-676）

摘要：

目的：探讨外周血及尿液中Dickkopf相关蛋白3(DKK3)对冠脉造影术后造影剂诱导的急性肾损伤(CI-AKI)的预测价值。方法：纳入2019年8月至2021年8月在东南大学附属中大医院行冠脉造影和经皮冠脉介入治疗(PCI)的患者466例，根据患者冠脉造影前后的血肌酐水平评估患者是否发生CI-AKI。采用ELISA法检测患者血及尿液中DKK3含量,单因素及多因素Logistic回归分析筛选CI-AKI的危险因素,受试者工作特征(ROC)曲线评估DDK3对CI-AKI的诊断价值。结果：466例患者中共有35例发生CI-AKI，发生率为7.5%。CI-AKI患者血DDK3和尿DKK3/尿肌酐值均高于非CI-AKI患者(均P＜0.05)。Logistic回归分析结果显示尿DKK3/尿肌酐值是CI-AKI的独立危险因素(OR=3.24,95%CI 2.61~4.92)。ROC曲线分析显示尿DKK3/尿肌酐值预测CI-AKI的曲线下面积(AUC)是0.659(95%CI 0.544~0.775,P=0.002)。结论：CI-AKI患者血DKK3和尿DKK3/尿肌酐值较未发生CI-AKI患者显著增加，尿DKK3/尿肌酐值对冠脉造影术后发生CI-AKI有良好的预测价值。

Objective: To investigate the predictive value of serum and urinary Dickkopf-related protein 3(DKK3) on contrast-induced acute kidney injury(CI-AKI) after coronary angiography. Methods: This study included 466 patients who underwent coronary angiography and percutaneous coronary intervention(PCI) from August 2019 to August 2021 in Zhongda Hospital Affiliated to Southeast University. Serum and urinary DKK3 levels were measured by ELISA. Univariate and multivariate logistic regression analysis were performed to identify the risk factors for CI-AKI. The predictive value of DDK3 for CI-AKI was assessed by receiver operating characteristic(ROC) curve analysis. Results: A total of 35(7.5%) in 466 patients developed CI-AKI after coronary angiography and PCI. The serum DKK3 and urinary DKK3/urinary creatinine ratio in patients with CI-AKI were higher than those in patients without CI-AKI(all P<0.05). Logistic regression analysis showed urinary DKK3/urinary creatinine ratio was an independent risk factor for CI-AKI(OR=3.24, 95% CI 2.61~4.92). ROC curve analysis showed that the area under the curve(AUC) of urinary DKK3/urinary creatinine ratio for predicting CI-AKI was 0.659(95%CI 0.544~0.775, P=0.002). Conclusion: Serum DKK3 and urinary DKK3/urinary creatinine ratio were significantly increased in patients with CI-AKI compared to those without CI-AKI, and urinary DKK3/urinary creatinine ratio has good predictive value on the occurrence of CI-AKI after coronary angiography.

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