早期肾损伤生物标志物在上尿路梗阻病人术前术后检测的临床意义  

Clinical significance of biomarker for early kidney injury in the preoperative and postoperative detection of upper urinary tract obstruction

作　　者：黄瑛[1] 卿克勤[1] 付虹[1] HUANG Ying;QING Keqin;FU Hong(Department of Laboratory Medicine,The First People′s Hospital of Chengdu,Chengdu 610041,China)

机构地区：[1]成都市第一人民医院检验科,四川成都610041

出　　处：《包头医学院学报》2018年第4期48-49,71,共3页Journal of Baotou Medical College

摘　　要：目的:探讨早期肾损伤生物标志物(尿中性粒细胞明胶酶相关脂质运载蛋白、血清胱抑素C)在上尿路梗阻病人术前术后检测的临床价值。方法:回顾性研究2015年1月至2017年5月经泌尿外科手术治疗的上尿路梗阻患者167例(梗阻组),肾功能检测其尿素、肌酐均为生物参考区间内,另选择健康对照者160名作为对照组,并对两组研究对象进行尿中性粒细胞明胶酶相关脂质运载蛋白(neutropil gelatinase-associated lipocalin,NGAL)、血清胱抑素C(cystatin C,CyC)水平检测并进行比较。结果:梗阻组患者术前NGAL、CyC中位数分别为:149.67 ng/mL、1.32 mg/L;术后分别为:65.24 ng/mL、0.91 mg/L;对照组:29.15 ng/mL,0.88 mg/L;不同组间的NGAL、CyC水平比较,差异均有统计学意义(P<0.05),进一步经Mann-Whitney秩和检验两两比较可知,术前梗阻组患者NGAL、CyC水平高于对照组(P<0.05),术前梗阻组患者NGAL、CyC水平高于术后梗阻组(P<0.05)。结论:NGAL、CyC作为早期肾损伤生物标志物联合检查有助于尿路梗阻病人肾脏损伤的评估和治疗方案的制定,也可以作为术后肾损伤修复的监测指标。Objective:To investigate the clinical significance of biomarker of urinary neutropil gelatinase-associated lipocalin(NGAL)and serum cystatin C(CyC)for early kidney injury in the preoperative and postoperative detection of upper urinary tract obstruction.Methods:A retrospective study was conducted from Jan.2015 to May 2017 in 167 patients with upper urinary tract obstruction whose urea and creatinine levels were within the biological reference range according to the renal function tests.Another 160 healthy people were enrolled as the control group.And then the levels of urinary NGAL and serum CyC were detected and compared between the two groups.Results:The median NGAL and CyC in the preoperative upper urinary tract obstruction group were 149.67ng/ml and 1.32mg/L.Those of the postoperative upper urinary tract obstruction group were 65.24 ng/ml and 0.91mg/L.The median NGAL and CyC in the healthy group were 29.15ng/ml and 0.88 mg/l.There were statistical differences in the levels of NGAL and CyC between the two groups.By the Mann-Whitney rank sum test,the levels of NGAL and CyC in the preoperative upper urinary tract obstruction group were significantly higher than those of the postoperative upper urinary tract obstruction group.Conclusion:The detection of the biomarker for early kidney injury is helpful in the evaluation of the renal injury and the formulation of the treatment regimen,which can be adopted as the postoperative monitoring index for renal injury repair.

关 键 词：上尿路梗阻 生物标志物 早期肾损伤 术后监测 

分 类 号：R699[医药卫生—泌尿科学]