肾结石患者输尿管软镜碎石术后早期尿NGAL与Cys C的变化  

Early Changes of uNGAL and uCys C in Renal Calculi Cases with the Flexible Ureteroscope and Laser Lithotripsy

作　　者：徐冀东[1] 姜宁[2] 王国增[2] 贺伟[2] 章璟[2] 郑景存[1] 

机构地区：[1]宁夏医科大学,银川750004 [2]上海市浦东新区公利医院泌尿外科,上海200135

出　　处：《宁夏医科大学学报》2013年第7期763-765,769,共4页Journal of Ningxia Medical University

基　　金：上海市卫生局科技项目基金(20124310);上海市浦东新区卫生局科技项目基金(PW2012A-8)

摘　　要：目的通过检测肾结石患者输尿管软镜钬激光碎石术(后称输尿管软镜碎石术)后不同时间点尿液NGAL(neutrophil gelatinase-associated lipocalin,uNGAL)与半胱氨酸蛋白酶抑制剂C(cystatin C,uCys C)的变化情况,探讨其判断肾结石输尿管软镜碎石术后早期肾功能(肾小管和肾小球)变化的意义。方法筛选肾结石患者30例,分别收集其输尿管软镜碎石术前及术后2、6、12、24h和1周的尿液及血清标本,检测不同时点患者uNGAL、uCys C浓度与血清肌酐(serum creatinine,Scr)的浓度。结果 uNGAL与uCys C在术后各时间点的浓度较术前均有明显增高,uNGAL在术后2h开始升高,在12h达到高峰,24h后下降(P<0.05);1周时基本恢复到术前水平(P>0.05)。uCys C在术后6h开始升高,在12h达到高峰,24h有所下降,1周时仍高于术前水平(P<0.05)。术后各时间点Scr无明显变化(P>0.05)。结论检测uNGAL与uCys C浓度可以作为评价肾结石输尿管软镜术后早期肾损伤的有效手段。Objective By detecting the urinary NGAL(uNGAL) and urinary Cystatin C(uCys C) of the patients after flexible ureteroscope laser lithotripsy at different times to determine the changes of early postoperative renal function(tubular and glomerular function) in renal calculi cases with flexible ureteroscope and laser lithotripsy.Methods Blood and urine samples at preoperative,and postoperative 2,6,12,24h and 1w were collected in 30 patients with kidney stones.uNGAL,uCys C and serum creatinine(Scr) concentration were detected.Results There was no significant changes in Scr between different postoperative time(P &gt; 0.05).The expression of uNGAL and uCys C showed significantly increased in postoperative time point than those in the preoperative time point.Urinary NGAL began to increase at postoperative 2h,peaked at postoperative 12h,declined after postoperative 24h,basically returned to preoperative levels at postoperative 1week.uCys C began to increase at postoperative 6h,peaked at postoperative 12h,declined after postoperative 24h,was still higher than preoperative levels at postoperative 1w.Conclusion Detecting uNGAL and uCys C concentration is a noninvasive and effective means of detection as evaluation of flexible ureteroscope laser lithotripsy early postoperative kidney injury.

关 键 词：中性粒细胞明胶酶相关载脂蛋白 半胱氨酸蛋白酶抑制剂C 肾结石 输尿管软镜 早期肾损伤 

分 类 号：R692.4[医药卫生—泌尿科学]