对比剂所致早期肾损伤时尿中性粒细胞明胶酶脂质运载蛋白的变化

目的：观察冠心病患者经皮冠状动脉腔内介入治疗术（PCI）后对比剂所致肾损伤时尿中性粒细胞明胶酶脂质运载蛋白（NGAL）的变化。方法：选择105例术前肾功能正常的行PCI术的冠心病患者,检测其手术前后不同时间点血肌酐（Scr）、尿NGAL水平和肾小球滤过率（GFR）。结果：术后有11例患者诊断为对比剂肾损伤,其尿NGAL水平异常较Scr提前至少24h。术后12h尿NGALROC曲线得出ROC曲线下的面积为0.824,AUC95%的可信区间为（0.735,0.913）。单变量分析示术前NGAL水平与GFR呈负相关,与年龄、血Scr浓度、血糖水平及糖尿病患病时间、血压水平及高血压患病时间呈正相关;术后尿NGAL水平与GFR呈负相关,与血Scr、手术时间呈正相关;多元Logistic回归分析显示血Scr及GFR是NGAL水平的独立影响因子。结论：尿NGAL对于冠心病患者PCI术后发生早期肾损伤具有良好的预测作用。

Changes of Urinary Neutrophil Gelatinase Associated Lipocalin in Contrast-induced Early Kidney Injury

Objective：To observe the changes of urinary neutrophil gelatinase associated lipocalin（NGAL）in contrast-induced early kidney injury after percutaneous coronary intervention（PCI）in patients with coronary artery disease.Methods：One hundred and five patients with normal renal function undergoing PCI were enrolled in this study.Serum creatinine（Scr）,urinary NGAL and glomerular filtration rate（GFR）were detected at different time points before and after PCI.Results：Serum creatinine was abnormal in 11 patients after PCI indicating early kidney injury,and the abnormal urinary NGAL appeared at least 24 hours earlier than serum creatinine.The area under the curve of ROC 12 hours after operation was 0.824,while the confidence interval of AUC 95% was（0.735,0.913）.It was found in univariate analysis that preoperative NGAL level was negatively correlated with GFR,and positively correlated with creatinine,age,level of blood glucose and disease course of diabetes and hypertension.After operation,level of NGAL was negatively correlated with GFR,positively correlated with blood creatinine and time for operation.Multiple logistic regression found that blood creatinine and GFR were the independent influencing factors of NGAL.Conclusion：Urinary NGAL might be an early biomarker for predicting early kidney injury in patients undergoing PCI.