NGAL和KIM-1在对比剂肾病诊治中的作用

Role of NGAL and KIM-1 on diagnostic effects and hydration therapy in patients with contrast-induced nephropathy

目的研究尿中性粒细胞明胶酶载脂蛋白(NGAL)和肾损伤分子1(KIM-1)在对比剂肾病诊断中的效果,探究水化治疗在对比剂肾病(CIN)治疗中的作用。方法选取2012年5月到2014年5月2年间在我院进行手术的经皮冠状动脉介入治疗(PCI)患者160例,采用随机分组的方式分为水化治疗组80例和对照组80例。对患者性别、年龄、患病情况以及用药量的基本信息进行收集;水化治疗组从PCI术前6小时给予静脉补液至术后12小时为止;采用ELISA法检测尿液中NGAL和KIM-1的含量;测定术前、术后3天、7天的血清肌酐(Scr)、和尿β2微球蛋(β2-MG)含量以及CIN的发病率。并对收集的数据进行统计学分析。结果对两组患者性别、年龄、患病情况以及用药量信息进行统计学分析,两组数据比较,差异不明显,不具有统计学意义(P>0.05),可以进行对比研究。在术后12小时两组患者NGAL和KIM-1含量显著增高,差异明显,具有统计学意义(P<0.05)。两组患者Scr和β2-MG的含量仅在术后3天差异明显,具有统计学意义(P<0.05),而其它时间点不具有统计学意义。CIN发病率水化治疗组明显低于对照组,两组数据比较差异明显,具有统计学意义(P<0.05)。结论 NGAL和KIM-1是诊断CIN的重要指标。水化疗法对CIN有积极的预防作用。

Objective To study the urinary neutrophil gelatinase-associated lipocalin（NGAL）and kidney injury molecule（KIM-1）on diagnosis of contrast-induced nephropathy and explore hydration therapy in contrast induced nephropathy（CIN）.Methods 160 patients with contrast-induced nephropathy were divided into hydration treatment group and the control group.The hydration treatment group received intravenous fluids to date from after 12 hbefore PCI6h.The urine NGAL and KIM-1were measured before surgery.Results The gender,age,prevalence and dosage information of the two groups were not statistically significant（P〉0.05）.NGAL and KIM-1after treatment were significantly higher than that before treatment（P〈0.05）.Incidence of CIN hydration treatment group was significantly lower than that of the control group（P〈0.05）.Conclusion NGAL and KIM-1is an important indicator of the diagnosis of CIN.Hydration therapies for the prevention of CIN have a positive effect.