vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2019-16-2-175-184vestim-494Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEДиагностика контраст-индуцированной нефропатии после чрескожного коронарного вмешательстваDiagnostics of contrastinduated nephropathy after percutaneous coronary interventionПырочкинА. В.PyrochkinA. V.

Пырочкин Александр Владимирович – канд. мед. наук, доцент

ул. П. Бровки, 3/3, 220013, г. Минск

Alexander V. Pyrochkin – Ph. D. (Med.), Assistant Professor

3/3, P. Browka Str., 220013, Minsk

morbid_ru@mail.ruПристромА. М.PrystromA. M.

Пристром Андрей Марьянович – д-р мед. наук, профессор, заведующий кафедрой

ул. П. Бровки, 3/3, 220013, г. Минск

Andrey M. Prystrom – D. Sc. (Med.), Professor, Head of the Department

3/3, P. Browka Str., 220013, Minsk

ПилотовичВ. С.PilotovichV. S.

Пилотович Валерий Станиславович – д-р мед. наук, профессор

ул. П. Бровки, 3/3, 220013, г. Минск

Valery S. Pilotovich – D. Sc. (Med.), Professor

3/3, P. Browka Str., 220013, Minsk

ГорецкаяД. Н.HoretskayaD. N.

Горецкая Данара Николаевна – врач-анестезиологреаниматолог, науч. сотрудник

ул. П. Бровки, 3/3, 220013, г. Минск

Danara N. Horetskaya – Anesthesiologist, Researcher

3/3, P. Browka Str., 220013, Minsk

ЮрагаТ. М.YuragaT. M.

Юрага Тамара Михайловна – ст. науч. сотрудник, руководитель отдела

ул. П. Бровки, 3/3, 220013, г. Минск

Tamara M. Yuraga – Senior researcher, Head of the Department

3/3, P. Browka Str., 220013, Minsk

БорисенкоТ. Д.BorisenkoT. D.

Борисенко Татьяна Дмитриевна – канд. мед. наук, заведующий отделением

пр. Независимости, 64, 220013, г. Минск

Tatyana D. Borisenko – Ph. D. (Med.), Head of the Department

64, Nezavisimosti Ave., 220013, Minsk

ВоробьеваЕ. А.VarabyovaE. A.

Воробьева Елизавета Александровна – мл. науч. сотрудник

ул. П. Бровки, 3/3, 220013, г. Минск

Elisaveta A. Varabyova – Junior researcher

3/3, P. Browka Str., 220013, Minsk

eli.mur@mail.ruСоловейО. М.SoloveyO, M.

Соловей Ольга Михайловна – ст. науч. сотрудник

ул. П. Бровки, 3/3, 220013, г. Минск

Olga M. Solovey – Senior researcher

3/3, P. Browka Str., 220013, Minsk

solo_som@mail.ruЧерноглазП. Ф.ChernoglazP. F.

Черноглаз Павел Феликсович – заведующий ангиографическим кабинетом, ассистент кафедры

Республиканский научно-практический центр детской хирургии

пр. Независимости, 64, 220013, г. Минск;

Белорусская медицинская академия последипломного образования

ул. П. Бровки, 3/3, 220013, г. Минск

Pavel F. Chernoglaz – Head of the catheterization laboratory, Assistant professor

Children’s Surgery National Research Hospital

64, Nezavisimosti Ave., 220013, Minsk;

Belarusian Medical Academy of Postgraduate Education

3/3, P. Browka Str., 220013, Minsk

ВеселовВ. В.VeselovV. V.

Веселов Владимир Владимирович – заведующий ангиографическим кабинетом

пр. Независимости, 64, 220013, г. Минск

Vladimir V. Veselov – Head of the catheterization laboratory

64, Nezavisimosti Ave., 220013, Minsk

ЛушниковаИ. Е.LushnikovaI. E.

Лушникова Инна Евгеньевна – заведующий отделением

пр. Независимости, 64, 220013, г. Минск

Inna E. Lushnikova – Head of the Department

64, Nezavisimosti Ave., 220013, Minsk

ПискуновС. Е.PiskunovS. E.

Пискунов Сергей Евгеньевич – заведующий отделением

пр. Независимости, 64, 220013, г. Минск

Sergey E. Piskunov – Head of the Department

64, Nezavisimosti Ave., 220013, Minsk

Белорусская медицинская академия последипломного образованияBelarusian Medical Academy of Postgraduate Education1-я городская клиническая больница1st Minsk City Clinical HospitalБелорусская медицинская академия последипломного образования1st Minsk City Clinical Hospital201901072019162175184Copyright © Пырочкин А.В., Пристром А.М., Пилотович В.С., Горецкая Д.Н., Юрага Т.М., Борисенко Т.Д., Воробьева Е.А., Соловей О.М., Черноглаз П.Ф., Веселов В.В., Лушникова И.Е., Пискунов С.Е., 20192019Пырочкин А.В., Пристром А.М., Пилотович В.С., Горецкая Д.Н., Юрага Т.М., Борисенко Т.Д., Воробьева Е.А., Соловей О.М., Черноглаз П.Ф., Веселов В.В., Лушникова И.Е., Пискунов С.Е.Pyrochkin A.V., Prystrom A.M., Pilotovich V.S., Horetskaya D.N., Yuraga T.M., Borisenko T.D., Varabyova E.A., Solovey O.M., Chernoglaz P.F., Veselov V.V., Lushnikova I.E., Piskunov S.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/494

Изучены возможности ранней диагностики развития контраст-индуцированной нефропатии при выполнении плановой коронарографии и чрескожного коронарного вмешательства у пациентов с хронической ишемической болезнью сердца, а также предикативные способности современных биомаркеров в сравнении с креатинином сыворотки. Исходный уровень β2-микроглобулина сыворотки >1,1 мг/л свидетельствует о высоком риске развития осложнений. При повышении через 24 ч уровней цистатина С (на 25 % от исходного, >1,064 мг/л) или β2-микроглобулина (>1,42 мг/л) в крови острое повреждение почек диагностируется раньше, чем по динамике креатинина, что может быть использовано в рутинной клинической практике. Определение уровня липокалина нейтрофилов в моче повышает точность диагностики, но затруднительно в рутинной практике.

The present study is devoted to search for the opportunities of early diagnosis of the development of contrastinduced nephropathy when performing coronary angiography and percutaneous coronary intervention in patients with a chronic ischemic heart disease. The predicative ability of modern biomarkers was studied in comparison with serum creatinine. Baseline serum β2-microglobulin levels >1.1 mg/l can be attributed to patients at a high risk of developing complications. Increasing the level of cystatin C in the blood by 25 % from baseline after 24 hours or >1.064 mg/l, increasing the level of β2-microglobulin in blood after 24 hours > 1.42 mg/l allows you to diagnose acute kidney damage, before the creatinine dynamics and can be used in routine clinical practice. The determination of neutrophil lipocalin in the urine improves the accuracy of diagnosis, but is difficult in routine practice.

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The authors declare that there are no conflicts of interest present.