尿液NGAL、α1-MG检测在输尿管镜钬激光碎石术后早期肾损害中的意义  

Evaluating Early Renal InJury after Ureteroscopic Holmium Laser Lithotripsy Based on Urinary NGAL and α1-MG Levels

作　　者：杨伟[1,2] 姜宁[2] 王国增[2] 章璟[2] 胡传义[2] 郑景存[2] 彭可[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》2014年第5期536-538,544,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：目的测定肾功能受损指标尿液中性粒细胞明胶酶相关运载蛋白(NGAL)及α1微球蛋白(α1-MG)的变化,探讨它们在输尿管镜钬激光碎石术后早期肾功能损害的意义。方法筛选输尿管结石患者40例,收集其输尿管镜碎石术前2h、术后2、6、12、24、48和72 h的尿液标本,检测分析尿液中NGAL、α1-MG的变化及其与碎石术手术时间、泵灌注压力的相关性。结果尿液NGAL在术后2 h开始上升(P<0.05),并在12 h达到峰值,随后开始下降,至72 h时仍高于基线值(P<0.05);尿液α1-MG浓度在术后2 h时与基线值比较差异无统计学意义(P>0.05),但于术后12 h时升高明显并于术后24'h达峰值,至术后72 h仍高于基线值(P<0.05)。同时尿液NGAL、α1-MG变化水平分别与手术时间、灌注压力呈正相关。结论输尿管镜碎石术后尿液NGAL、α1-MG变化水平是反映肾早期损害的敏感指标并与手术时间、灌注压力呈正相关。Objective To evaluate the early renal injury response to ureteroseopic holmium laser lithotripsy （URL） by measuring the urinary excretion of the renal injury markers neutrophil gelatinase - associated lypocalin （NGAL） and α1 -microglobulin （α1 -MG）. Methods 40 patients with ureteral stones who were treated by URL were recruited. Urine samples were obtained at baseline（2h before） ,2,6,12,24,48 ,and 72h after URL. Urinary NGAL and α1 - MG levels were measured using standard ELISA kits. The correlations be- tween their changes and operating time or perfusion pressure were analyzed. Results Urinary NGAL began to rise 2 h after lithotripsy and was significantly different from the baseline （ P 〈 0.05 ）. The peak NGAL occurred at 12 h and followed decline. It was still significantly different from the baseline at 72h （P 〈 0.05 ）. There was no significant difference of urinary al - MG levels between 2h after lithotripsy and baseline. 12 hours after URL. Urinary oL1 - MG increased significantly （P 〈 0.05 ） and reached peak at 24h. Theα1 - MG levels of 72h measured after URL were still significantly different from the baseline（P 〈 0.05 ）. The magnitude of rise in NGAL and α1 -MG were positively associated with operating time and perfusion pressure. Conclusion U- rinary NGAL and oL1 -MG levels significantly increased post -URL treatment suggesting a potential role for these urinary markers in early identifying the kidney tissue injury and these makers were positively associated with operating time and perfusion pressure.

关 键 词：输尿管镜碎石术 NGAL Α1-MG 因素分析 

分 类 号：R699[医药卫生—泌尿科学]