NGAL、α1-MG检测在评估输尿管镜钬激光碎石术后早期肾损害的应用研究

发布时间：2018-06-28 15:08

本文选题：输尿管镜碎石术 + uNGAL　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的通过测定肾功能受损指标尿液中性粒细胞明胶酶相关运载蛋白（NGAL）及α１微球蛋白（α1-MG）的变化，探讨输尿管镜钬激光碎石术后早期肾功能损害的影响因素。研究NGAL及α1-MG在输尿管镜术后的变化规律及临床意义，为选择检测输尿管镜术后肾功能损伤的指标提供依据。方法筛选输尿管结石患者40例，收集其输尿管镜碎石术前2h、术后2、6、12、24、48、72h的尿液标本，，用ELISA法检测NGAL、α1-MG的浓度，分析尿液中NGAL、α1-MG的变化及其与手术时间、泵的压力的相关性。结果不同患者的各时间点尿液NGAL和α1-MG浓度的变化有显著差异（P0.05）。40例患者输尿管镜碎石术后尿液NGAL及α1-MG浓度较术前有明显变化，且表现出一定规律性。尿液NGAL在术后2h开始上升，与基线值比较差异有统计学意义(P0．05)，并在12h达到峰值，随后开始下降，至72h时仍高于基线值，差异仍有统计学意义(PO，05)；尿液α1-MG浓度晚于NGAL于术后12h方才开始升高，并于术后24h达峰值，至术后72h仍高于基线值，差异均有统汁学意义(P0．05)，何时将至基线水平无统计学意义。同时尿液NGAL、α1-MG变化水平分别与手术时间、灌注压力呈正相关。结论输尿管镜碎石术后尿液NGAL、α1-MG变化水平是反映肾早期损害的敏感指标并与手术时间、灌注压力有相关性。提示尿液NGAL与α1-MG是判定输尿管镜钬激光碎石术后早期肾损伤的有效监测指标，为临床诊治肾损伤提供客观依据。
[Abstract]:Objective to determine the changes of urinary neutrophil gelatinase-associated transport protein (NGAL) and 伪 _ 1-microglobulin (伪 _ 1-MG) in patients with renal function impairment and to explore the influencing factors of early renal function damage after ureteroscopic holmium: YAG laser lithotripsy. To study the changes and clinical significance of NGAL and 伪 1-MG after ureteroscopy, and to provide evidence for the selection of indicators for the detection of renal function injury after ureteroscopy. Methods 40 patients with ureterolithiasis were selected. The urine samples were collected 2 hours before ureteroscopic lithotripsy and 72 hours after ureteroscopic lithotripsy. The concentrations of NGALand 伪 1-MG were detected by Elisa, and the changes of NGALand 伪 1-MG in urine and their correlation with operation time and pump pressure were analyzed. Results the concentrations of NGAL and 伪 1-MG in urine of 40 patients with ureteroscopic lithotripsy were significantly different from those before ureteroscopic lithotripsy at different time points (P0.05), and there were some regularity in urine NGAL and 伪 1-MG concentrations after ureteroscopic lithotripsy. Urine NGAL began to rise at 2 hours after operation, the difference was statistically significant compared with baseline value (P0.05), and reached the peak at 12 hours, then began to decrease, and was still higher than the baseline value at 72 hours, the difference was still statistically significant (POP05). The concentration of urine 伪 1-MG increased only 12 hours after the operation than NGAL, and reached the peak at 24 hours after the operation, and was still higher than the baseline value at 72 hours after the operation. The difference was statistically significant (P0.05), but there was no statistical significance when the level of 伪 1-MG reached the baseline level. At the same time, the levels of urinary NGALand 伪-1-MG were positively correlated with the time of operation and perfusion pressure. Conclusion the changes of urinary NGALand 伪 1-MG levels after ureteroscopic lithotripsy are sensitive markers for early renal damage and are correlated with the operative time and perfusion pressure. These results suggest that urinary NGAL and 伪 1-MG are effective indicators for early renal injury after ureteroscopic holmium laser lithotripsy, and provide an objective basis for clinical diagnosis and treatment of renal injury.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699

【参考文献】