Department of Invasive Cardiology, Medical University, Bialystok, Poland.
Adv Med Sci. 2009;54(2):221-4. doi: 10.2478/v10039-009-0036-1.
The value of NGAL (neutrophil gelatinase-associated lipocalin) and L-FABP (liver-type fatty acid binding protein) has been highlighted as a novel biomarker of detection of acute renal failure in children after cardiac surgery. Interventional cardiologists are being asked more frequently to perform percutaneous coronary intervention (PCI) and contrast nephropathy is its potentially serious complication. We aimed to prospectively assess NGAL and L-FABP in patients with normal serum creatinine undergoing PCI due to unstable angina.
We measured serum NGAL, urinary NGAL and L-FABP using commercially available kits before and after 2, 4, 12, 24 and 48 hours following PCI in 25 patients.
We found a significant rise in serum NGAL after 2 and 4 hours. Urinary NGAL and urinary L-FABP followed the same pattern. Both markers increased significantly after 4 hours and remained elevated up to 48 hours after PCI. Serum creatinine did not change significantly during the study period.
NGAL and L-FABP may represent a sensitive early biomarkers of renal impairment after PCI. Persistently increased urinary NGAL and L-FABP may suggest renotubular damage in this population.
中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肝型脂肪酸结合蛋白(L-FABP)的价值已被强调为心脏手术后儿童急性肾衰竭检测的新型生物标志物。介入心脏病专家越来越频繁地被要求进行经皮冠状动脉介入治疗(PCI),而对比肾病是其潜在的严重并发症。我们旨在前瞻性评估因不稳定型心绞痛而行 PCI 的血清肌酐正常患者的 NGAL 和 L-FABP。
我们使用商业试剂盒在 25 例患者行 PCI 前及后 2、4、12、24 和 48 小时测量血清 NGAL、尿 NGAL 和 L-FABP。
我们发现血清 NGAL 在 2 小时和 4 小时后显著升高。尿 NGAL 和尿 L-FABP 呈现相同的模式。两种标志物在 4 小时后显著增加,并在 PCI 后 48 小时内持续升高。血清肌酐在研究期间没有显著变化。
NGAL 和 L-FABP 可能是 PCI 后肾损伤的敏感早期生物标志物。持续升高的尿 NGAL 和 L-FABP可能表明该人群存在肾小管损伤。