血清中性粒细胞明胶酶相关脂质运载蛋白检测在造影剂肾病诊断中的临床意义

发布时间：2018-09-19 10:38

【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(P0.05),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。
[Abstract]:Objective to investigate the significance of serum neutrophil gelatinase-associated lipid carrier protein (NGAL) in the diagnosis of contrast agent nephropathy (CIN). Methods 299 patients with ICU, cardiovascular department and urology were selected from Guangdong traditional Chinese Medicine Hospital. Fasting blood glucose and blood lipid were measured and their basic clinical data were recorded. The serum levels of serum creatinine (SCr), cysteine protease inhibitor C (CysC) and NGAL were collected before and 6 days after angiography. Patients with 44 渭 mol/L or more than 25% increase in 24~48hSCr level after angiography were analyzed for the trend of serum NGAL detection at different time points by CIN,. Results there were 28 cases of CIN in 299 patients, the incidence rate was 9.36%. The incidence of CIN was 16.21% (12 / 74) in patients with diabetes and 7.11% (16 / 225) in patients without diabetes. The levels of SCr and CysC in patients with cin were significantly higher than those before angiography on the 2nd day after angiography, and returned to the pre-contrast level on the 6th day, and the serum NGAL levels increased significantly on the 1st day after angiography. The difference was statistically significant (P0.05) and was still at a high level on the 6th day. Conclusion Serum NGAL level can be used to predict CIN, 1 day after contrast medium use. The prediction time of CIN, is earlier than that of SCr and CysC,. It can be used in the early diagnosis of CIN.
【作者单位】：广东省中医院检验科;广东省中医院二沙岛分院泌尿外科;
【基金】：国家中医药行业科研专项项目(201007005) 广东省中医药局项目(20121188)
【分类号】：R692

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