冠状动脉介入术后中性粒细胞明胶酶相关脂质运载蛋白水平变化的研究

Change of Neutrophil Gelatinase - associated Lipocalin Levels in Patients Undergoing Coronary Angiography and Percutaneous Coronary Intervention

目的观察冠状动脉造影术(CAG)和(或)经皮冠状动脉腔内介入治疗术(PCI)患者手术前后尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平的变化,探讨尿NGAL对对比剂肾损伤的预测作用。方法选择60例接受CAG和(或)PCI的患者,检测其手术前后不同时间点血肌酐(SCr)、肾小球滤过率(GFR)和尿NGAL水平。结果 60例患者术前和术后24 h及48 h SCr、GFR水平比较,差异无统计学意义(P>0.05),无一例因对比剂发生肾损伤。NGAL水平在术后6、12、24 h显著升高,与术前比较差异有统计学意义(P<0.05)。结论在冠状动脉介入术后SCr变化不明显的患者尿NGAL水平已显著升高,提示NGAL对对比剂肾损伤的早期预测作用要优于SCr。

Objective To observe the level of neutrophil gelatinase-associated lipocalin（NGAL） in patients undergoing coronary angiography（CAG） and/or percutaneous coronary intervention（PCI） procedure before and after the operation（s） and to explore the value of NGAL in predicting contrast-induced acute renal injury（CI-AKI）.Methods Totally 60 patients undergoing CAG and/or PCI were enrolled in this study.Serum creatinine（SCr）,glomerular filtration rate（GFR）,and urinary NGAL were detected at different time points before and after operation（s）.Results Of all these 60 patients,the changes of SCr and GFR levels were not statistically significant before and after operation（s）（P 0.05）.No CI-AKI cases was noted.The urine NGAL levels 6,12,and 24 hours after operation（s） significantly increased when compared with the baseline levels（P 0.05）.Conclusion Urinary NGAL remarkably increases after coronary interventional therapy in patients without obvious change of SCr levels,indicating that urinary NGAL has a superior effectiveness than SCr in predicting CI-AKI.