床边快速检测NGAL对急诊冠脉介入后造影剂所致急性肾损伤预测的多中心研究

Multicenter clinical study of the predictive value of neutrophil gelatinase-associated lipocalin for contrastinduced acute kidney injury after emergency percutaneous coronary intervention in patients with relative normal renal function

目的:探讨中性粒细胞明胶酶载脂蛋白(NGAL)对肾功能相对正常患者行急诊冠脉介入(PCI)后造影剂所致急性肾损伤(CI-AKI)的早期预测价值。方法:入选2014年12月至2015年8月因急性心梗于广东省人民医院、茂名市人民医院和东莞市人民医院行急诊PCI且肾功能相对正常[e GFR>60 m L(min·1.73 m2)]患者73例。采用床边快速检测仪测定血NGAL。利用受试者工作曲线(ROC)评估NGAL对CI-AKI的预测价值。结果:5例(6.85%)患者发生CI-AKI,且其NGAL水平高于非CI-AKI组。ROC曲线显示,术前、术后4 h及8 h NGAL对CI-AKI有较高预测价值,曲线下面积分别为0.755、0.761、0.809。结论术前、术后4 h及8 h床边快速检测NGAL对行急诊PCI且肾功能相对正常患者发生CI-AKI有较高预测价值,今后可能成为诊断早期CI-AKI的快速手段。

Objective To explore the predictive value of neutrophil gelatinase associated lipocalin （NGAL） for contrast-induced acute kidney injury （CI-AKI） after emergency percutaneous coronary interventions （PCI） in patients with relative normal renal function. Methods A total of 73 patients with relative normal renal function undergoing PCI were enrolled in this prospective muhicenter clinical study. Serum NGAL was measured by point-of-care test. Receiver operating characteristic （ROC） curve was used to analyze the diagnostic value of NGAI, for CI-AKI. Results CI-AKI occurred in 5 patients （6.85%）. The concentration of NGAI, was higher in the CI-AKI group than in the non-CI-AKI group. ROC curve indicated that the area under the receiver operating characteristic was 0.755, 0.761 and 0.809, respectively. Conclusions Serum NGAL at baseline, 4 h and 8 h after procedure are served as a good biomarker for early diagnosis of CI-AKI after PCI. Therefbre, NGAL might become an early and quick marker for CI-AKI in the future.