血清胱抑素C与尿中性粒细胞明胶酶相关载脂蛋白对冠心病患者介入术后对比剂肾病的诊断价值

Diagnostic value of serum cystatin C and urinary neutrophil gelatinase-associated lipocalin in contrast-induced nephropathy of patients with coronary heart disease after interventional therapy

目的:探讨血清胱抑素C(Cys-C)与尿中性粒细胞明胶酶相关载脂蛋白(NGAL)对冠心病患者介入术后对比剂肾病(CIN)的诊断价值。方法:回顾性分析2018年1月至2020年2月该院收治的126例冠心病患者的临床资料。比较CIN、非CIN患者介入术后24 h血清Cys-C、尿NGAL、血肌酐(Scr)水平。采用受试者工作特征(ROC)曲线分析血清Cys-C、尿NGAL、Scr水平对CIN的诊断价值。结果:CIN患者的血清Cys-C、尿NGAL和Scr水平均明显高于非CIN患者,差异有统计学意义(P<0.05);血清Cys-C、尿NGAL及联合检测诊断CIN的曲线下面积(AUC)分别为0.858、0.869和0.932;血清Cys-C、尿NGAL及联合检测的AUC、灵敏度、特异度均高于Scr,且血清Cys-C联合尿NGAL检测的AUC、灵敏度、特异度均高于二者单独检测,差异有统计学意义(P<0.05)。结论:血清Cys-C、尿NGAL对冠心病患者介入术后CIN的诊断效能较高,且血清Cys-C联合尿NGAL检测的诊断效能高于二者单独检测。

Objective:To explore diagnostic value of serum cystatin C(Cys-C)and urinary neutrophil gelatinase-associated lipocalin(NGAL)in contrast-induced nephropathy(CIN)of patients with coronary heart disease after interventional therapy.Methods:A retrospective analysis of the clinical data of 126 patients with coronary heart disease admitted to the hospital from January 2018 to February 2020 was performed.The serum Cys-C,urine NGAL and Scr levels were compared among the CIN patients and the non-CIN patients 24 h after the intervention.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum Cys-C,urine NGAL,and Scr levels for CIN.Results:The serum Cys-C,urine NGAL and Scr levels of the CIN patients were significantly higher than those of the non-CIN patients,and the differences were statistically significant(P<0.05).The areas under the curve(AUC)of serum Cys-C,urine NGAL and combined detection of CIN were 0.858,0.869 and 0.932,separately.The AUC,sensitivity,and specificity of serum Cys-C,urine NGAL and combined detection were higher than those of Scr;the AUC,sensitivity,and specificity of the combined detection of serum Cys-C and urine NGAL were higher than those of single Cys-C and single urine NGAL;and the differences were statistically significant(P<0.05).Conclusions:Serum Cys-C and urine NGAL have high diagnostic efficiency for the CIN patients with coronary heart disease after interventional therapy.Moreover,the diagnostic efficiency of the combined detection of serum Cys-C and urine NGAL is higher than those of single Cys-C and single urine NGAL.