Department of Nephrology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji'nan, China; Department of Diagnostics, BinZhou Medical University, Yantai, Shandong, China.
Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
Am J Med Sci. 2021 Jun;361(6):736-743. doi: 10.1016/j.amjms.2020.10.028. Epub 2020 Nov 2.
Acute kidney injury (AKI) is increasingly being seen in patients with acute coronary syndromes (ACS) and it is associated with higher short-term and long-term morbidity and mortality. Therefore, it is of paramount importance to identify those ACS patients at risk for the development of AKI. The objective of this study was to evaluate two different plasma biomarkers calprotectin and neutrophil gelatinase-associated lipocalin (NGAL) in early detecting the development of AKI in ACS patients.
172 ACS patients admitted to the Coronary Care Unit in Yantai Yuhuangding Hospital were prospectively enrolled. Their blood samples were obtained on admission and subjected to enzyme-linked immunosorbent assay to determine the levels of novel biomarkers. The clinical data and biomarkers were recorded and analyzed.
In this study, 23 (13.4%) patients had a diagnosis of AKI. Statistical analysis demonstrated that in ACS patients with AKI, the following two biomarkers were significantly higher than these without AKI: plasma calprotectin (5942.26 ± 1955.88 ng/mL vs. 3210.29 ± 1833.60 ng/mL, p < 0.001) and plasma NGAL (164.91 ± 43.63 ng/mL vs. 122.48 ± 27.33 ng/mL, p < 0.001). Plasma calprotectin and NGAL could discriminate the development of AKI respectively with an area under the ROC curve (AUC) of 0.864 and 0.850. A combination of the two plasma biomarkers calprotectin and NGAL could early discriminate AKI in ACS patients with an AUC of 0.898.
This study demonstrated a promising panel of plasma calprotectin and NGAL as early diagnostic biomarkers for AKI in ACS patients.
急性肾损伤（AKI）在急性冠状动脉综合征（ACS）患者中越来越常见，与较高的短期和长期发病率和死亡率相关。因此，识别那些有发生 AKI 风险的 ACS 患者至关重要。本研究的目的是评估两种不同的血浆生物标志物钙卫蛋白和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在早期检测 ACS 患者 AKI 发展中的作用。
前瞻性纳入 172 例入住烟台毓璜顶医院冠心病监护病房的 ACS 患者。入院时采集其血样，通过酶联免疫吸附试验测定新型生物标志物的水平。记录并分析临床数据和生物标志物。
本研究中，23 例（13.4%）患者诊断为 AKI。统计分析表明，在发生 AKI 的 ACS 患者中，以下两种生物标志物显著高于未发生 AKI 的患者：血浆钙卫蛋白（5942.26±1955.88ng/mL 比 3210.29±1833.60ng/mL，p<0.001）和血浆 NGAL（164.91±43.63ng/mL 比 122.48±27.33ng/mL，p<0.001）。血浆钙卫蛋白和 NGAL 分别能够区分 AKI 的发生，ROC 曲线下面积（AUC）分别为 0.864 和 0.850。联合两种血浆生物标志物钙卫蛋白和 NGAL 可以早期区分 ACS 患者的 AKI，AUC 为 0.898。
本研究表明，血浆钙卫蛋白和 NGAL 作为 ACS 患者 AKI 的早期诊断生物标志物具有广阔的前景。
