PCI后新型生物标记物对术中对比剂引起急性肾损伤的预测作用

目的探讨PCI后新型生物标记物对术中对比剂引起急性肾损伤（AKI）的预测作用。方法选择稳定型心绞痛及急性冠脉综合征行PCI治疗患者200例，根据AKI诊断标准分为AKI组16例及正常组184例。于PCI术前及术后不同时间分别测定新型生物标记物血浆中性粒细胞明胶酶相关载脂蛋白（NGAL）、血浆半胱氨酸蛋白酶抑制剂c（CystatinC）、尿NGAL、尿肾脏损伤因子-1（Kim-1）变化情况，并以受试者工作特征曲线及曲线下面积（AUC）评价各项标志物诊断AKI的临床意义。结果①两组术前血浆NGAL、血CystatinC、尿NGAL及尿Kim-1无统计学差异（P均〉0．05）。②与术前相比，AKI组术后以上生物标记物水平均比术前升高，且差异有统计学意义（P均〈0．01）。结论PCI后AKI患者某些生物学标志物水平显著升高，可以成为AKI的早期诊断方法。

Early biomarkers for prediction of contrast-induced acute kidney injury after PCI

Objective To explore predictive effects of early biomarkers on the contrast-induced acute kidney injury （CIAKI） after PCI. Methods Totally 200 cases of patients with stable angina and acute coronary syndrome which under- went PCI were selected. According to AKI diagnostic criteria, they were divided into the AKI group （ 16 cases） and normal group （ 184 cases）. The changes of plasma neutrophil gelatinase-associated lipocalin （ NGAL）, plasma cystatin C, urine NGAL, and urine kidney injury molecule-1 （ Kim-1 ） were measured before and after PCI. The area under the ROC curve （AUC） was used to evaluate the early diagnostic value of all biomarkers for AKI. Results （1） There was no significant difference in plasma NGAL, plasma cystatin C, urine NGAL and urine Kim-1 levels between the two groups before PCI （ all P 〉 0.05 ）. （2） In the AKI group, the levels of biomarkers after PCI were significantly higher as compared with the levels before the operation （ all P 〈 0.01 ）. Conclusion The biomarkers of AKI after PCI significantly increase, and can be used in the early diagnosis of AKI after PCI.