胱抑素C及β2-微球蛋白中性粒细胞明胶酶相关脂质运载蛋白联合检测在肺癌患者化疗相关肾损伤早期检测中的作用  

The value of measuring cysC, β2-microglobulin and neutrophil gelatinase-associated lipocalin as a test panel for detection of early renal damage in lung cancer patients receiving chemotherapy

作　　者：熊胜春[1] 吴静 井洪家 刘建伟[1] 马建欣[1] 王玉慧[2] Xiong Shengchun, Wu Jing ,Jing Hongjia ,Liu Jianwei ,Ma Jianxin ,Wang Yuhui(Department of Cardiothoracic Surgery ,Chengde Central Hospital, Chengde 067000, China ; Department of Nephrology, Chengde Central Hospital, Chengde 067000 ,China)

机构地区：[1]承德市中心医院心胸外科,067000 [2]承德市中心医院肾内科,067000

出　　处：《中华老年医学杂志》2018年第10期1107-1110,共4页Chinese Journal of Geriatrics

基　　金：承德市科学技术研究与发展计划项目（201707A004）

摘　　要：目的探讨胱抑素C、β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白与传统指标肌酐、血尿素在肺癌患者化疗后肾脏早期功能损伤的检测上的应用价值。方法选择本院63例60岁以上肺癌患者，采用前瞻性研究，检测化疗前后血清胱抑素C、尿液β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白与传统指标血清肌酐、尿素水平，根据化疗时间节点将数据分为化疗前、化疗当天和化疗结束组。结果肺癌患者化疗后血清胱抑素C、尿液β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白水平均明显升高，而血清肌酐、尿素水平升高不明显，随着接触化疗药物后的时间延长，前三者水平继续升高；化疗当日CysC、β2-MG、NGAL三组敏感性的多样本率的Pearson X2=31．32，P=0．00，化疗结束日，CysC、β2-MG、NGAL三组敏感性的多样本率的Pearson x2=60．38，P=0．00。结论肺癌患者化疗后血清胱抑素C、尿液β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白对肾脏早期功能损伤有较好的诊断作用，是肾脏早期功能损伤的理想检测指标，优于传统肾功能检测项目血清肌酐、尿素。Objective To compare the value of serum cystatin C （CysC） ,urine β2-microglobulin （β2-MG）, and neutrophil gelatinase-associated lipocalin （NGAL） as a test panel with that of traditional indicators,serum Cr and urea, for detection of early renal damage in lung cancer patients after chemotherapy. Methods This prospective study collected data at our hospital on levels of serum cystatin C （CysC）, urine β2 microglobulin （β2-MG）, and neutrophil-gelatinase associated lipocalin （NGAL） from 63 lung cancer patients aged 60 and over. In addition, levels of traditional indicators including serum Cr and urea were also measured. Participants were divided into three groups： a prechemotherapy group, an under chemotherapy group, and a post-chemotherapy group. Results Levels of serum CysC,urine β2-MG,and NGAL in the post-chemotherapy group markedly increased, whereas levels of serum Cr and urea had no significant increase; furthermore,levels of serum CysC, urine β2-MG, and NGAL went up steadily as the time of exposure to chemotherapy drugs increased. Pearson＇s test showed that the sensitivity of CysC, beta 2-MG and NGAL as a panel was statistically significant for both the under chemotherapy group and the post-chemotherapy group （x2 = 31.32,P=0. 00;x2 =60.38,P=0. 00）. Conclusions Serum CysC, urine β2-MG and NGAL as a panel have good diagnostic value for early renal function damage in lung cancer patients after chemotherapy and are superior to traditional renal function indicators such as serum creatinine and urea.

关 键 词：肺肿瘤 化疗方案 肾功能损伤 中性粒细胞明胶酶相关脂质运载蛋白 胱抑 素C 

分 类 号：R734.2[医药卫生—肿瘤] R692[医药卫生—临床医学]