【摘要】 目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)检测在造影剂肾病(CIN)诊断中的意义。方法选取广东省中医院各院区ICU、心血管科、泌尿外科等接受造影技术诊治的患者299例,检测患者空腹血糖、血脂等,记录其基本临床资料。采集患者在造影前及造影后第1、2、6天的血样,分析患者各时间点的血清肌酐(SCr)、半胱氨酸蛋白酶抑制剂C(CysC)和NGAL水平。以造影后24~48hSCr水平升高44μmol/L或较基础值上升25%以上患者为CIN,分析血清NGAL检测在不同时间点的变化趋势。结果 299例受检患者中,共发生CIN 28例,发病率为9.36%。其中患有糖尿病的患者中CIN发病率为16.21%(12/74),无糖尿病的患者发病率为7.11%(16/225)。与造影前比较,CIN患者SCr和CysC在造影后2d明显升高,到第6天恢复到造影前水平;血清NGAL水平在造影后1d就明显升高,与造影前比较差异有统计学意义(P<0.05),在第6天仍处于较高水平。结论血清NGAL水平在造影剂使用后1d就可较好地预测CIN,其预测时间早于SCr和CysC,可用于CIN的早期诊断。更多还原

【Abstract】 Objective To discuss the clinical significance of serum neutrophil gelatinase associated lipocalin(NGAL)detection in the diagnosis of contrast induced nephropathy.Methods A total of 299 inpatients with contrast medium in department of intensive care unit(ICU),department of cardiovascular disease,department of urology from Guangdong Province Hospital of Traditional Chinese Medicine were enrolled,and the fasting blood glucose and lipids were detected.Sera were collected before examination of contrast medium and 1,2and 6dafter examination of contrast medium respectively.Serum creatinine(SCr)and cystatin C(CysC)were detected,the concentration of NGAL was determined.CIN was defined as of increased by 44μmol/L or 25%from baseline in SCr within 24-48 h.The NGAL detection variation tendency was analyzed in different time point.Results In 299 cases,CIN occurred in 28 patients,the incidence rate was 9.36%.The diabetes patients in the incidence of CIN was 16.21%(12/74),no incidence of diabetic patients was 7.11%(16/225).When compared with that of before contrast,CIN in serum of patients with Cr and CysC coronary angiography in 2dsignificantly increased after contrast medium,returned to the level before angiography on 6d.But the serum NGAL in angiography 1dafter it was significantly increased(P<0.05),statistically significant differences compared with pre contrast,and was still at a high level on sixth day.Conclusion Prediction of CIN level of serum NGAL in contrast after 1d could be a good predictor for CIN,and the prediction time is earlier than the serum levels of Cr and CysC.The level of serum NGAL can be used for early diagnosis of CIN.更多还原