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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

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【作者】 王坤谭宁刘勇陈纪言谢年谨余丹青薛凌叶健烽梁岩

【Author】 WANG Kun;TAN Ning;LIU Yong;CHEN Jiyan;XIE Nianjin;YU Danqin;XUE Ling;YE Jianfeng;LIANG Yan;Department of Graduate School,Southern Medical University;

【机构】 南方医科大学研究生学院广东省人民医院,广东省医学科学院,广东省心血管病研究所,南方医科大学广东省人民医院,广东省医学科学院,广东省心血管病研究所心内科广东省东莞市人民医院广东省茂名市人民医院

【摘要】 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。

【Abstract】 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 renalfunction undergoing PCI were enrolled in this prospective multicenter clinical study.Serum NGAL was measured bypoint-of-care test.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of NGALfor CI-AKI.Results CI-AKI occurred in 5 patients(6.85%).The concentration of NGAL was higher in the CI-AKIgroup than in the non-CI-AKI group.ROC curve indicated that the area under the receiver operating characteristicwas 0.755,0.761 and 0.809,respectively.Conclusions Serum NGAL at baseline,4 h and 8 h after procedure areserved as a good biomarker for early diagnosis of CI-AKI after PCI.Therefore,NGAL might become an early andquick marker for CI-AKI in the future.

【基金】 2012年中国医师协会阳光心血管研究基金项目(编号:SCRFCMDA201216);2014年广东省科技厅公益研究与能力建立项目(编号:2014A020212635)
  • 【文献出处】 实用医学杂志 ,The Journal of Practical Medicine , 编辑部邮箱 ,2017年04期
  • 【分类号】R692;R542.22
  • 【被引频次】11
  • 【下载频次】92
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