血清NT-proBNP及尿液NGAL水平对冠心病支架置入术患者对比剂肾病的早期预测价值

发布时间：2018-04-27 20:12

本文选题：冠状动脉疾病 + 对比剂肾病　；参考：《山东医药》2017年01期

【摘要】：目的观察冠心病患者支架置入术后血清N末端B型利钠肽前体(NT-proBNP)、尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平变化,探讨二者对对比剂肾病(CIN)的早期预测价值。方法选择行支架置入术冠心病患者108例,以术后发生CIN患者12例作为CIN组,按照2∶1比例随机选取非CIN患者24例(非CIN组)。测定两组手术前后血清肌酐(Cr)、尿素氮(BUN)、NT-proBNP水平以及尿液NGAL水平,以ROC曲线分析血清NT-proBNP和尿液NGAL早期预测CIN的临床价值。结果手术后48 h,CIN组血清Cr、BUN水平均明显高于非CIN组(P均0.01);术后3、6、12、24、48 h,CIN组血清NT-proBNP水平均高于非CIN组(P均0.01),CIN组尿液NGAL水平均高于非CIN组(P均0.01);血清NT-proBNP水平、尿液NGAL水平均与术后48 h的血清Cr、BUN水平呈正相关(P均0.01)。术后12 h,血清NT-proBNP的ROC曲线下面积为0.701±0.048,尿液NGAL为0.825±0.029,血清NT-proBNP与尿液NGAL联合后为0.911±0.021。术后12 h血清NT-proBNP、尿液NGAL水平及其二者联合对CIN均有早期预测价值(P均0.01),且NT-proBNP和尿液NGAL两个指标联合检测早期预测CIN的价值更高(P均0.01)。结论冠心病患者支架置入术后血清NT-proBNP、尿液NGAL水平能更早反应肾功能变化,对CIN发生具有早期预测价值。
[Abstract]:Objective to observe the changes of serum N-terminal B-type natriuretic peptide precursor (NT-proBNPN) and urinary neutrophil gelatinase-associated lipid carrier protein (NGALs) in patients with coronary heart disease (CHD) after stenting, and to explore the early predictive value of NT-proBNPN and urinary neutrophil gelatinase-associated lipid carrier protein (NGALs) in patients with coronary heart disease (CHD). Methods one hundred and eight patients with coronary heart disease underwent stent implantation, 12 patients with CIN were selected as CIN group, and 24 patients with non- (non- group) were randomly selected according to 2:1 ratio. The serum creatinine (Cr), the level of NT-proBNP and the level of urine NGAL were measured before and after operation in both groups. The clinical value of early prediction of CIN in serum NT-proBNP and urine NGAL was analyzed by ROC curve. Results the serum Cr bun level in the cin group was significantly higher than that in the non CIN group at 48 h after operation, the serum NT-proBNP level in the cin group was significantly higher than that in the non CIN group at 48 h after operation, and the level of serum NT-proBNP in the cin group was higher than that in the non CIN group, and the serum NT-proBNP level in the cin group was significantly higher than that in the non CIN group at 48 h after operation. There was a positive correlation between urine NGAL level and serum Cr bun level at 48 h after operation (P < 0.01). At 12 hours after operation, the area under the ROC curve of serum NT-proBNP was 0.701 卤0.048, the area of urine NGAL was 0.825 卤0.029, and the area of serum NT-proBNP combined with urine NGAL was 0.911 卤0.021. Serum NT-proBNPs, urine NGAL levels and their combination with NT-proBNPs had early predictive value for CIN at 12 h after operation (P < 0.01), and NT-proBNP and urine NGAL were more valuable in early prediction of CIN than those in urine (P < 0.01). Conclusion Serum NT-proBNPand urine NGAL levels in patients with coronary heart disease after stent implantation can respond to renal function changes earlier and have early predictive value for the occurrence of CIN.
【作者单位】：重庆医科大学附属第一医院第一分院;重庆市人民医院;
【基金】：重庆市卫生计生委医学科研面上项目(2015MSXM001)
【分类号】：R541.4;R692

【相似文献】