血、尿NGAL早期诊断心脏外科术后急性肾损伤的临床价值分析  

NGAL levels in blood and urine in early diagnosis of acute renal injury after cardiac surgery

作　　者：杨恒[1] 张润生[1] 胡亚兰[1] Yang Heng;Zhang Runsheng;Hu Yalan(Department of Cardiac Surgery, Zhengzhou Seventh People's Hospital, Zhengzhou 450000, China)

机构地区：[1]郑州市第七人民医院心脏外科,450000

出　　处：《国际医药卫生导报》2019年第7期1082-1085,共4页International Medicine and Health Guidance News

摘　　要：目的探讨血、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)早期诊断心脏外科术后急性肾损伤(AKI)的临床价值.方法随机选取2014年1月至2017年12月本院收治的120例心脏手术患者,于术前与术后采集患者血尿标本,分别测定患者血、尿NGAL及血肌酐(Scr)水平,依据检测结果分为急性肾损伤组(AKI组)与非急性肾损伤组(非AKI组).检测两组术前、术后不同时间点血、尿NGAL水平及Scr水平变化情况并通过受试者工作特征(ROC)评价NGAL(血、尿)对AKI的诊断价值.结果 AKI组术后2、6、12、24 h血、尿NGAL水平与术前(基础值)和非AKI组比较,差异均具有统计学意义(均P< 0.05),而术后6h血NGAL水平与术后2h尿NGAL水平均在最高峰值(均P<0.05);术后6h血NGAL灵敏度为73.4%,特异度为75.8%,阳性、阴性预测值分为61.4%、62.4%,曲线下面积(AUC)为0.782,95% CI为0.346-0.954;术后2h尿NGAL灵敏度为86.7%,特异度为92.4%,阳性、阴性预测值分为68.7%、72.5%,曲线下面积(AUC)为0.894,95% CI为0.462-0.948.结论血、尿NGAL可作为心脏外科手术早期诊断AKI的标志物,具有重要临床应用价值.Objective To investigate the clinical value of NGAL levels in blood and urine in the early diagnosis of acute renal injury after cardiac surgery.Methods From January,2014 to December,2017,120 patients undergoing cardiac surgery at our hospital were selected.Their blood and urine samples were collected before and after the operation.The levels of neutrophil gelatinase-related lipid-carrying eggs (NGAL) in blood and urine as well as serum creatinine (Scr) were measured.According to the results,the patients were divided into an acute kidney injury group (AKI group) and non-acute kidney injury group (non-AKI group).The levels of NGAL in blood and urine as well as Scr were measured before the operation and at different time points after the operation.The diagnostic value of NGAL (blood and urine) in AKI was evaluated by ROC.Results The levels of NGAL in blood and urine 2,61,12,and 24 h after the operation in the AKI group were significantly different from those before the operation (baseline value) and those in the non-AKI group (all P < 0.05).The NGAL level got to the peak 6 h after the operation in blood and 2 h in urine (both P < 0.05).The sensitivity,specificity,positive and negative predictive values,the area under curve (AUC),and 95% CI of NGAL in blood 6 h after the operation were 73.4%,75.8%,61.4%,62.4%,0.782,and 0.346-0.954;and those of NGAL in urine 2 h after the operation were 86.7%,92.4%,68.7%,72.5%,0.894,and 0.462-0.948.Conclusions NGAL levels in blood and urine can be used as markers for the early diagnosis of AKI after cardiac surgery,and have important clinical value.

关 键 词：血NGAL 尿NGAL 心脏外科术 急性肾损伤 

分 类 号：R654.2[医药卫生—外科学] R692.5[医药卫生—临床医学]