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目的探讨肿瘤坏死因子样凋亡微弱诱导剂(TWEAK)水平和造影剂肾病(CIN)的相关性。方法行冠状动脉(冠脉)造影的慢性肾功能不全患者400例,根据血清TWEAK检测结果分为A组(TWEAK<450pg/ml,134例)、B组(450pg/ml≤TWEAK<550pg/ml,133例)和C组(TWEAK≥550pg/ml,133例),比较三组的CIN发生率。结果 400例患者术后发生CIN患者共53例(13.3%),其TWEAK水平高于未发生CIN患者(P<0.05)。B组住院期间CIN发生率高于A组、低于C组(13.5%vs.8.2%、18.0%)(P<0.05)。校正年龄、左心室射血分数、糖尿病、肾小球滤过率等因素后,与A组比较,C组冠脉造影后发生CIN的风险显著增加(OR=1.45,95%CI:1.12~2.64,P<0.01)。结论冠脉造影患者的TWEAK水平和CIN发生率显著相关,高TWEAK水平可能增加冠脉造影后CIN发生率。
Objective To investigate the correlation between the level of tumor necrosis factor-like weak apoptosis inducer (TWEAK) and contrast agent nephropathy (CIN). Methods Four hundred patients with chronic renal insufficiency undergoing coronary angiography were divided into group A (TWEAK <450pg / ml, 134 cases) and group B (450pg / ml≤ TWEAK <550pg / ml , 133 cases) and group C (TWEAK≥550 pg / ml, 133 cases). The incidence of CIN in the three groups was compared. Results A total of 53 patients (13.3%) with CIN were found in 400 patients. The TWEAK level was higher than those without CIN (P <0.05). The incidence of CIN in group B was higher than that in group A and lower than that in group C (13.5% vs.8.2%, 18.0%, P <0.05). After adjustment for age, left ventricular ejection fraction, diabetes mellitus, glomerular filtration rate and other factors, the risk of developing CIN after coronary angiography was significantly increased in group C compared with group A (OR = 1.45, 95% CI: 1.12-2.64 , P <0.01). Conclusions There is a significant correlation between TWEAK level and CIN incidence in coronary angiography. High TWEAK level may increase the incidence of CIN after coronary angiography.