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评价血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿肾损伤分子-1(KIM-1)在造影剂肾病(CIN)中的诊断试验。

Evaluation of a Diagnostic Test of Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Urine KIM-1 in Contrast-Induced Nephropathy (CIN).

机构信息

Department of Geriatrics, Qinghai Provincial People's Hospital, Xining, Qinghai, China (mainland).

出版信息

Med Sci Monit. 2019 Jan 19;25:565-570. doi: 10.12659/MSM.912569.

Abstract

BACKGROUND The aim of this study was to assess changes in serum neutrophil gelatinase-associated lipocalin (NGAL) and urine KIM-1 after percutaneous coronary intervention (PCI). MATERIAL AND METHODS A total of 240 patients receiving coronary stent implantation were selected. All patients were divided into 2 groups: a CIN group (n=25) and a non-CIN group (n=215). The serum creatinine (SCr), NGAL, and urine KIM-1 levels of the patients in both groups were measured before and after surgery, and the sensitivity of serum NGAL and urine KIM-1 in diagnosing CIN in the early stage was assessed by the area under receiver operating characteristic (ROC) curve (ROC-AUC). RESULTS In the CIN group, the serum NGAL and urine KIM-1 levels started to rise at 6 h after surgery. The serum NGAL and urine KIM-1 levels in CIN group were significantly higher than those in the non-CIN group at 6, 12, 24, and 48 h after surgery. However, the SCr levels in the CIN group were not higher than those in the non-CIN group at 6 h after surgery. At 6, 12, and 24 h after PCI, the AUCs for serum NGAL and urine KIM-1 were increased compared with that for SCr, while the AUCs for serum NGAL and urine KIM-1 were decreased at 48 h after PCI compared with that for SCr. CONCLUSIONS Serum NGAL and urine KIM-1 levels in the patients after coronary stent implantation can reflect the changes in renal functions early, thus providing a certain basis for the early diagnosis of CIN.

摘要

背景

本研究旨在评估经皮冠状动脉介入治疗(PCI)后血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿肾损伤分子-1(KIM-1)的变化。

材料与方法

选择 240 例接受冠状动脉支架植入术的患者。所有患者分为 2 组:CIN 组(n=25)和非 CIN 组(n=215)。两组患者术前均检测血清肌酐(SCr)、NGAL 和尿 KIM-1 水平,采用受试者工作特征曲线(ROC)下面积(ROC-AUC)评估血清 NGAL 和尿 KIM-1 对早期 CIN 的诊断价值。

结果

CIN 组患者血清 NGAL 和尿 KIM-1 水平于术后 6 h 开始升高,术后 6、12、24、48 h 时 CIN 组血清 NGAL 和尿 KIM-1 水平明显高于非 CIN 组,而 CIN 组患者术后 6 h 时的 SCr 水平与非 CIN 组无差异。PCI 术后 6、12、24 h 时,血清 NGAL 和尿 KIM-1 的 AUC 均高于 SCr,而 PCI 术后 48 h 时血清 NGAL 和尿 KIM-1 的 AUC 均低于 SCr。

结论

冠状动脉支架植入术后患者血清 NGAL 和尿 KIM-1 水平可早期反映肾功能变化,为早期诊断 CIN 提供一定依据。

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