尿 NGAL 在对比剂肾病早期诊断中的临床意义

目的：探讨中性粒细胞明胶酶相关载脂蛋白（ NGAL）对冠状动脉诊治术后对比剂肾病的早期诊断的临床意义。方法选取我院心内科2012年5月-2013年4月使用非离子型低渗造影剂进行血管造影的80名成年患者，所有患者分别于冠状动脉诊治术前24 h内、术后12 h，24 h和48 h抽血检测Scr。同时于术前24 h内，术后2h收集尿液检测NGAL。所有入选的患者以发生对比剂肾病（CIN）的病例为CIN组（以48 h的Scr为诊断标准），从未发生CIN病例中选取2．5倍CIN组例数的患者作为非CIN组。结果 CIN组冠状动脉诊治术后2 h尿NGAL浓度较术前24 h的尿NGAL浓度显著升高（P＜0．05）；非CIN组冠状动脉诊治术后2 h的尿NGAL浓度较术前24 h的尿NGAL浓度无明显统计学差异（P＞0．05）。结论冠状动脉诊治术后2 h尿液NGAL可以作为早期诊断CIN的参考指标。

Clinical significance of NGAL in early diagnosis of contrast-induced nephropathy

Objective To investigate the clinical significance of neutrophil gelatinase -associated lipocalin （ NGAL） in ear-ly diagnosis of contrast-induced nephropathy （ CIN） .Methods 80 cases of adult patients were selected from our hospital be-tween May 2012 and April 2013 who underwent angiography using non-ionic low-osmolar contrast media .All patients＇Scr was tested within 24h before and 12h,24h,and 48h after the coronary artery treatment respectively .NGAL was tested within 24h before and 2h after the treatment by collecting urine .Of all the selected cases ,those who developed CIN were set up as a CIN group based on the diagnostic standard of 48h Scr.Out of the cases without CIN ,2.5 times the number of CIN group＇s cases were chosen to form a non-CIN group.Results 2h after the treatment , the urinary NGAL concentration of the CIN group was significantly higher than that 24h before the treatment （P0.05）.Conclusion 2h after the coronary artery treatment ,the urinary NGAL may serve as an early reference index for the diagnosis of CIN .