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。
Objective To observe the changes of serum N terminal pro-B-type natriuretic peptide （NT-proBNP）and urine neutrophil gelatinase-associated lipocalin （NGAL）levels in patients with coronary heart disease after stent implanta-tion and to investigate their early prediction value for contrast-induced nephropathy （CIN）.Methods Totally 108 cases of patients with coronary heart disease receiving stent implantation were enrolled.After stent implantation,12 patients had CIN,who were taken as the CIN group.Meanwhile,24 patients without CIN were randomly selected according to the ratio of 2∶1,who were taken as the non-CIN group.The levels of serum creatinine （Cr）,blood urea nitrogen （BUN）,NT-proBNP and urine NGAL were measured before and after the operation.The early prediction value of serum NT-proBNP and urine NGAL for CIN was estimated by receiver operating characteristic （ROC）curve analysis.Results The levels of ser-um Cr and BUN in the CIN group were significantly higher than those in the non-CIN group at 48 h after operation （all P 〈0.01）.The levels of serum NT-proBNP and urine NGAL in the CIN group were significantly higher than those in the non-CIN group at 3,6,12,24,and 48 h （all P 〈0.01）.The levels of serum NT-proBNP and urine NGAL were positively correlated with serum levels of Cr and BUN at 48 h after operation （all P 〈0.01）.At 12 h after operation,the AUCs were calculated as 0.701 ±0.048 for serum NT-proBNP and 0.825 ±0.029 for urine NGAL,when we combined the serum NT-proBNP and urine NGAL,the AUC was 0.911 ±0.021.At 12 h after the operation,serum NT-proBNP,urine NGAL and the combination of them all had early predictive value for CIN （all P 〈0.01）,besides,the combination of them had higher＆nbsp;predictive value for CIN at the early stage （all P 〈0.01）.Conclusion For patients with coronary heart disease after stent implantation,NT-proBNP and NGAL levels can early reflect the kidney function,and have early prediction value for CIN.
作者
邓颖
葛平
计蕾
DENG Ying GE Ping JI Lei(The First Branch, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400011, China)
出处
《山东医药》
CAS
北大核心
2017年第1期15-18,共4页
Shandong Medical Journal
基金
重庆市卫生计生委医学科研面上项目(2015MSXM001)
