摘要
目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合血清胱抑素C(Cys-C)早期诊断冠心病患者造影剂肾病(CIN)的临床价值。方法选取2015年5月—2017年12月收治的128例行支架置入术治疗的冠心病,观察CIN的发生情况,检测尿NGAL、血清Cys-C、肌酐(Scr)和尿白介素-18(IL-18)水平,分析尿NGAL与血清Cys-C、Scr、尿IL-18的相关性。结果本组经支架置入介入术治疗后CIN发生率为14. 06%。治疗后,CIN组尿NGAL、IL-18及血清Cys-C、Scr水平均较治疗前升高(P <0. 05)。冠心病患者中CIN组尿NGAL、IL-18及血清Cys-C和Scr阳性检出率均高于非CIN组(P <0. 01)。尿NGAL与血清Cys-C、Scr、尿IL-18均呈正相关性(r=0. 286、0. 326、0. 342,P <0. 05)。尿NGAL联合血清Cys-C共同检测对早期诊断冠心病患者CIN的灵敏度和特异度高于尿NGAL、血清Cys-C、尿IL-8和血清Scr单独检测(P <0. 05)。结论在冠心病CIN患者中尿NGAL和血清Cys-C水平均显著升高,且联合检测对早期诊断冠心病患者CIN具有较高的灵敏度和特异度,故认为可将其作为早期诊断冠心病患者CIN的首选检测指标。
Objective To investigate clinical value of urinary neutrophil gelatinase associated lipocalin (NGAL) combined with serum cystatin C (Cys-C) in early diagnosis of radiographic contrast nephropathy in patients with coronary heart disease. Methods A total of 128 coronary heart disease patients with stent implantation admitted during May 2015 and December 2017 were selected to observe incidence rate of radiographic contrast nephropathy. Levels of urinary NGAL, serum Cys-C, creatinine (Scr) and urinary interleukin-18 (IL-18) were detected, and correlations between urinary NGAL with serum Cys-C, Scr and IL-18 were analyzed. Results Incidence rate of radiographic contrast nephropathy in the 128 patients after stent implantation was 14.06%. After treatment, urinary NGAL, IL-18, serum Cys-C and Scr levels were significantly higher than those before treatment in radiographic contrast nephropathy group ( P <0.05). Among patients with coronary heart disease, positive rates of urinary NGAL, IL-18, serum Cys-C and Scr in radiographic contrast nephropathy group were significantly higher than those in non-radiographic contrast nephropathy group ( P <0.01). Urinary NGAL was positively correlated with serum Cys-C, Scr and urinary IL-18 ( r =0.286, 0.326, 0.342, P < 0.05). Values of sensitivity and specificity of urinary NGAL combined with serum Cys-C in early diagnosis of radiographic contrast nephropathy in patients with coronary heart disease were significantly higher than those by urinary NGAL or serum Cys-C, urinary IL-8 and serum Scr detections only ( P <0.05). Conclusion Urinary NGAL and serum Cys-C levels are significantly higher in coronary heart disease patients with radiographic contrast nephropathy, and combined detection has high sensitivity and specificity in early diagnosis of radiographic contrast nephropathy in patients with coronary heart disease, and therefore it can be used as the first index for early diagnosis of radiographic contrast nephropathy in patients with coronary heart disease.
作者
沈钢
周依林
杨健睿
SHEN Gang;ZHOU Yi-lin;YANG Jian-rui(Department of Medical Laboratory, Medical School of 3201 Hospital Affiliated to Xi'an Jiao Tong University, Hanzhong, Shaanxi 723000, China)
出处
《解放军医药杂志》
CAS
2019年第4期52-56,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省科学技术研究发展计划项目(2015K15116)
关键词
冠心病
造影剂肾病
尿中性粒细胞明胶酶相关脂质运载蛋白
胱抑素C
Coronary Disease
Radiographic contrast nephropathy
Urinary neutrophil gelatinase associated lipocalin
Cystatin C
