尿白细胞介素-18联合血清胱抑素C早期诊断造影剂肾病价值  

Significance joint detection of urine interleukin-18 and serum cystatin C in early diagnosis of contrast-induced nephropathy

作　　者：王美钧[1] 郑钧元[2] 柴红燕[3] 喻明霞[3] 涂建成[3] 

机构地区：[1]武汉大学第二临床学院基因诊断中心,武汉430071 [2]十堰市人民医院口腔科,湖北十堰442000 [3]武汉大学中南医院检验科,武汉430071

出　　处：《中华实用诊断与治疗杂志》2015年第5期473-475,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家973项目(2012CB720600)子课题(2012CB720605)

摘　　要：目的探讨联合检测尿白细胞介素-18(interleukin-18,IL-18)和血清胱抑素C水平在诊断冠心病患者行经皮冠状动脉造影及/或冠状动脉介入术后发生造影剂肾病中的临床意义。方法冠心病患者431例,均行经皮冠状动脉造影术及/或冠状动脉介入术,术后发生造影剂肾病62例(CIN组),未发生造影剂肾病369例,从369例中随机选择62例为对照组,2组均于术前及术后12、24、48h采用酶底物直接显色法检测血清肌酐水平,采用免疫比浊法检测血清胱抑素C水平,于术前和术后12h采用ELISA法检测尿IL-18水平,并进行比较。结果术前CIN组尿IL-18[(12.17±3.52)ng/L]和血清胱抑素C水平[(1.22±0.53)mg/L]与对照组[(11.56±3.48)ng/L、(1.15±0.48)mg/L]比较差异无统计学意义(P>0.05);术后12hCIN组尿IL-18[(31.21±7.36)ng/L]和血清胱抑素C[(3.32±0.78)mg/L]水平明显高于对照组[(14.25±4.45)ng/L、(1.32±0.51)mg/L]和术前(P<0.05);术后24hCIN组血清肌酐水平[(252.15±68.73)μmol/L]明显高于对照组[(124.12±31.26)μmol/L](P<0.05);CIN组尿IL-18和血清胱抑素C水平均与血清肌酐水平呈正相关(r=0.893,P=0.011;r=0.653,P=0.015)。结论联合检测尿IL-18和血清胱抑素C水平可早期诊断造影剂肾病。Objective To investigate the clinical significance of joint detection of urine interleukin-18（IL-18）and serum cystatin C in the early diagnosis of contrast-induced nephropathy（CIN）after coronary angiography in patients with coronary heart disease.Methods In 431 patients with coronary heart disease undergoing coronary angiography and/or coronary stenting,62 patients had CIN（CIN group）and 369 had no CIN in which 62 patients were randomly selected as controls（control group）.The serum creatinine levels were detected before and 12,24 and 48hours after coronary angiography by chromogenix substrate method,the serum cystatin C levels were detected by immunoturbidimetry,and the urine IL-18 levels were detected by ELISA before and 12 hours after operation.Results There were no significant differences in IL-18 and cystatin C levels before operation between CIN group（（12.17±3.52）ng/L,（1.22±0.53）mg/L）and control group（（11.56±3.48）ng/L,（1.15±0.48）mg/L）（P0.05）.The levels of IL-18 and cystatin C were significantly higher in CIN group（（31.21±7.36）ng/L,（3.32±0.78）mg/L）than those in control group（（14.25±4.45）ng/L,（1.32±0.51）mg/L）12hours after operation（P0.05）,and were significantly higher than those before operation in CIN group（P 0.05）.The creatinine level was higher in CIN group（（252.15±68.73）umol/L）than that in control group（（124.12±31.26）umol/L）24hours after operation（P0.05）.In CIN group,IL-18 and cystatin C were positively correlated with creatinine（r=0.893,P=0.011;r=0.653,P=0.015）.Conclusion The joint detection of urine IL-18 and serum cystatin C can be used as an sensitive method for the early diagnosis of CIN.

关 键 词：造影剂肾病 尿白细胞介素-18 血清胱抑素C 

分 类 号：R692[医药卫生—泌尿科学]