尿肝型脂肪酸结合蛋白用于对比剂肾病预后评价的临床对照研究

Controlled clinical research on the prognostic evaluation of application of urine liver fatty acid-binding protein in contrast-induced nephropathy

目的 探讨尿肝型脂肪酸结合蛋白（尿L-FABP）在对比剂肾病预后中的临床诊断效果。方法 选取2013年4月~2014年4月我院收治的40例对比剂肾病患者为实验组,选择同期入院的40例其他肾病患者为对照组,观察两组尿L-FABP、尿素氮（BUN）、血肌酐（Scr）、尿微量蛋白（m ALB）、尿α1-微球蛋白（α1-MG）、24 h尿蛋白定量（24hpro）、尿β2-微球蛋白（β2-MG）、血尿酸（SUA）等指标。结果 实验组BUN、Scr、尿L-FABP、m ALB、α1-MG、24hpro、β2-MG、SUA等水平高于对照组（P〈0.05）;e GFR水平低于对照组（P〈0.05）。尿L-FABP和BUN、Scr、m ALB、α1-MG、24hpro、β2-MG、SUA等指标之间表现为正相关（P〈0.05）,与e GFR表现为负相关（P〈0.05）。BUN、α1-MG是尿L-FABP水平的影响因素（P〈0.05）。结论 动态监测对比剂肾病尿L-FABP水平可指导患者治疗预后。

Objective To investigate clinical diagnosis effect of urine liver fatty acid-binding protein（urine L-FABP） on contrast-induced nepbropathy prognosis. Methods Selected 40 cases of contrast-induced nephropathy patients who had been received and cured in our hospital from April 2013 to April 2014 as the experimental group, besides, 40 cases of other nephrotic patients during the corresponding period were also selected as the control group, the following indica- tors： urine L-FABP, blood urea nitrogen（BUN）, serum creatinine（Scr）, microalbuminuria（mALB）, urine α1-microglobulin （α1-MG）, 24h urine protein quantitation（24hpro）, urine [β-microglobulin（β2-MG）, blood uric acid（SUA） and so on were observed. Results The indicators of BUN, Scr, urine L-FABP, mALB, α1-MG, 24hpro, ~2-MG, SUA of experimental group were proved higher than those of control group （P〈0.05）; eGFR of experimental group was proved lower than that of control group （P〈0.05）. The indicators of urine L-FABP, BUN, Scr, mALB, α1-MG, 24hpro, β2-MG, SUA had posi- tive correlation with each other（P〈0.05）, but they had negative correlation with eGFR （P〈0.05）; BUN and α1-MG were proved to be the influence factors of urine L-FABP （P〈0.05）. Conclusion It is proved that the dynamic monitoring of urine L-FABP level of contrast-induced nephropathy could guide patients＇ treatment prognosis.