尿NGAL与Cys-C在输尿管软镜碎石术后早期肾功能变化的研究  

Study of uNGAL and uCys C in the change of early postoperative renal function in the flexible ureteroscope laser lithotripsy

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

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

出　　处：《宁夏医学杂志》2013年第8期700-702,共3页Ningxia Medical Journal

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：目的探讨尿中性粒细胞明胶酶相关载脂蛋白NGAL(uNGAL)与半胱氨酸蛋白酶抑制剂C(uCys-C)的表达对输尿管软镜碎石术后患者早期肾功能的影响及其变化规律。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、术后2、6、12、24 h、1 w的血液及尿液标本,检测患者uNGAL、uCys-C浓度与血清肌酐(Scr)浓度对比,分析不同时点的表达情况。结果术后各时间点Scr无明显变化,差异无统计学意义(P>0.05)。uNGAL与uCys-C在术后各时间点的表达较术前均有明显变化,且有一定规律。uNGAL在术后2 h开始升高,在12 h达到高峰,24 h后下降,1 w时基本恢复到术前水平。uCys-C在术后6 h开始升高,在12 h达到高峰,24 h有所下降,1 w时仍高于术前水平。结论输尿管软镜碎石术后uNGAL与uCys-C浓度明显升高,提示输尿管软镜术对肾小管和肾小球功能均有轻度影响,输尿管软镜碎石术引起的肾小管损伤的表达早于肾小球损伤。检测uN-GAL与uCys-C浓度可以作为评价输尿管软镜术后早期肾损伤有效的检测手段。Objective To detect the urinary NGAL （uNGAL） and urinary Cystatin C uCys- C） of the patients after flexible ureteroscope laser lithotripsy at different times to determine the impact of flexible ureteroscope laser lithotripsy to early postoperative renal function （ tubular and glomerular function）, and observe the early postoperative variation of both after the flexible ureteroscope laser lithotripsy. Methods 30 patients with kidney stones were collected their blood and urine specimens preoperative, and postoperative 2h,6h, 12h,24h, 1 w, and detected the patients＇uNGAL,uCys- C and serum creatinine （Scr） concentration, analyzed the expression of different times. Results The study found that, there was no significant changes in Scr （P 〉 0.05） in different postoperative time. The expression of uNGAL and uCys - C had certain variation, embodied in the expression of postoperative uNGAL and uCys - C changed significantly compared with the preoperative. Urinary NGAL began to increase at postoperative 2h, peak at postoperative 12h, decline after postopera- tive 24h, basically returned to preoperative levels at postoperative 1 w. uCys - C began to increase at postoperative 6h, peak at postoperative 12h,decline after postoperative 24h,is still higher than preoperative levels at postoperative lw. Conclusion The postoperative uN- GAL and uCys - C concentration significantly increase, and there is certain variation, prompt that the flexible ureteroscope laser lithotripsy has lighter effect on both tubular and glomerular function, but more obvious than Scr. Urinary NGAL increase significantly at postoperative 2h and uCys -C increase significantly at postoperative 6h, this suggests flexible ureteroscope laser lithotripsy cause renal tubular injury earlier than glomerular injury. Detecting uNGAL and uCys - C concentration is 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]