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[1]宋艳梅,车京津,陈康寅,等.CHA2DS2-VASc评分对慢性肾脏疾病患者冠状动脉支架内再狭窄的预测价值[J].天津医科大学学报,2024,30(01):65-69.[doi:10.20135/j.issn.1006-8147.2024.01.0065]
　SONG Yanmei,CHE Jingjin,CHEN Kangyin,et al.The predictive value of CHA2DS2-VASc score for coronary in-stent restenosis in patients with chronic kidney disease[J].Journal of Tianjin Medical University,2024,30(01):65-69.[doi:10.20135/j.issn.1006-8147.2024.01.0065]
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CHA2DS2-VASc评分对慢性肾脏疾病患者冠状动脉支架内再狭窄的预测价值(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
30卷
期数:
2024年01期
页码:
65-69
栏目:
临床医学
出版日期:
2024-01-01

文章信息/Info

Title:
The predictive value of CHA2DS2-VASc score for coronary in-stent restenosis in patients with chronic kidney disease
文章编号:
1006-8147(2024)01-0065-05
作者:
宋艳梅; 车京津; 陈康寅; 徐延敏; 李广平; 刘彤; 张晓伟
（天津医科大学第二医院心脏科，天津市心血管离子与分子机能重点实验室，天津心脏病学研究所，天津 300211）
Author(s):
SONG Yanmei; CHE Jingjin; CHEN Kangyin; XU Yanmin; LI Guangping; LIU Tong; ZHANG Xiaowei
（Department of Cardiology，The Second Hospital，Tianjin Medical University，Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease，Tianjin Institute of Cardiology，Tianjin 300211，China）
关键词:
冠状动脉支架内再狭窄; CHA2DS2-VASc评分; 慢性肾脏疾病
Keywords:
coronary in-stent restenosis; CHA2DS2-VASc score; chronic kidney disease
分类号:
R541.4
DOI:
10.20135/j.issn.1006-8147.2024.01.0065
文献标志码:
A
摘要:
目的：探讨CHA2DS2-VASc评分对慢性肾脏疾病（CKD）患者冠状动脉支架内再狭窄（ISR）的预测价值。方法：分析2019年1月—2022年1月行冠状动脉支架置入的CKD患者147例，平均年龄（66.6±10.9）岁，67.3%为男性。CKD的定义为根据MDRD公式得出的估算肾小球滤过率（eGFR）<60 mL/（min·1.73 m2）。根据是否发生冠状动脉ISR将患者分为ISR组（53例）和非ISR组（94例）。冠状动脉ISR定义为支架面积与正常直径相比狭窄>50%。收集患者基线临床资料、实验指标，计算术前CHA2DS2-VASc评分。采用多因素Logistic回归分析评估CHA2DS2-VASc评分对CKD患者发生冠状动脉ISR的影响。绘制受试者工作特征（ROC）曲线，评估CHA2DS2-VASc评分对CKD患者冠状动脉ISR的预测价值。结果：与非ISR组相比，ISR组糖尿病比例、单核细胞绝对值、CHA2DS2-VASc评分更高，eGFR、左室射血分数水平更低（χ2=4.714，t=-3.605，Z=-2.997、-4.938，均P<0.05）。多因素Logistic回归分析结果显示，ISR组单核绝对值（OR=24.106，95%CI：2.500～232.395，P=0.006）、eGFR（OR=0.906， 95%CI：0.858～0.956，P<0.001）和CHA2DS2-VASc评分（OR=1.377，95%CI：0.999～1.899，P=0.020）是CKD患者发生冠状动脉ISR的独立危险因素。ROC曲线显示，CHA2DS2-VASc评分预测CKD患者发生冠状动脉ISR的曲线下面积（AUC）为0.646，95%CI为 0.557~0.735，敏感性为83.0%，特异性为55.3%。结论：CHA2DS2-VASc评分对CKD患者发生冠状动脉ISR的预测有临床应用价值。
Abstract:
Objective： To investigate the predictive value of CHA2DS2-VASc score for coronary in-stent restenosis（ISR） in patients with chronic kidney disease（CKD）. Methods： From January 2019 to January 2022，147 patients with CKD who had undergone successful stent implantation were included，with mean age of（66.6±10.9） years，67.3% being men. CKD was defined as the estimated glomerular filtration rate（eGFR）<60 mL/（min·1.73 m2） based on the formula of modification of diet in renal disease（MDRD）. According to whether coronary ISR occurred，patients were divided into ISR group（n=53） and non-ISR group（n=94）. Coronary ISR was defined as narrowing >50% in a stent area compared to normal diameter. The baseline clinical data and experimental indexes were collected，and the preprocedural CHA2DS2-VASc scores were calculated. Multivariate Logistic regression analysis was used to evaluate the effect of CHA2DS2-VASc score on coronary ISR in patients with CKD. The predictive value of CHA2DS2-VASc score for coronary ISR in patients with CKD was evaluated by receiver operating characteristic（ROC） curve. Results： Compared with the non-ISR group，the ISR group had higher rates of diabetes，monocyte absolute value，CHA2DS2-VASc score，and lower levels of eGFR and left ventricular ejection fraction（χ2=4.714，t=-3.605，Z=-2.997，-4.938，all P<0.05）. Multivariable Logistic regression found that absolute mononuclear values（OR=24.106，95%CI：2.500-232.395，P=0.006），eGFR（OR=0.906，95%CI：0.858-0.956，P<0.001），and CHA2DS2-VASc score（OR=1.377，95%CI：0.999-1.899，P=0.020） were independent predictors of coronary ISR in patients with CKD. ROC curve showed that the area under the curve（AUC） of CHA2DS2-VASc score in predicting coronary ISR in patients with CKD was 0.646 （95%CI：0.5577-0.735），with a sensitivity of 73.6% and a specificity of 52.1%. Conclusion： CHA2DS2-VASc score has clinical application in predicting the occurrence of coronary ISR in patients with CKD.

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备注/Memo

备注/Memo:
基金项目 天津市医学重点学科（专科）建设项目（TJYXZDXK-029A）
作者简介 宋艳梅（1995-），女，硕士在读，研究方向：常见心血管病的基础与临床研究；通信作者：张晓伟，E-mail：doczxw@126.com。
更新日期/Last Update: 2024-01-01