NGAL、铁调素及CysC水平在造影剂肾病早期诊断中的应用  

Application of NGAL,hepcidin and CysC levels in the early diagnosis of contrast induced nephropathy

作　　者：吴秋杰[1] 张靖华[1] 刘金瑞[1] 赵占锋 王长安[1] WU Qiujie;ZHANG Jinghua;LIU Jinrui;ZHAO Zhanfeng;WANG Changan(Department of Kidney Transplant and Nephrology,Zhengzhou Seventh People's Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州市第七人民医院肾移植肾内科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2022年第7期1192-1195,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(2019020816)。

摘　　要：目的分析中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、铁调素及胱抑素C(CysC)水平在造影剂肾病(CIN)早期诊断中的应用价值。方法收集2020年1月至2021年9月郑州市第七人民医院收治且应用含碘造影剂进行影像学检查的287例患者的临床资料,观察CIN发生情况,采用多因素条件Logistic回归模型分析影响CIN发生的的危险因素。比较发生CIN与未发生CIN患者NGAL、铁调素及CysC水平;并绘制受试者工作特征曲线(ROC)分析上述因子检测对CIN的诊断价值。结果287例患者中,发生CIN者26例(CIN组),未发生CIN者261例(无CIN组)。造影后,两组NGAL、铁调素及CysC水平均较造影前增高,且CIN组上述因子水平均高于无CIN组,差异有统计学意义(P<0.05)。经单因素分析显示,糖尿病、高血压、原肾功能不全、NGAL、铁调素及CysC为影响CIN发生的单因素(P<0.05)。将单因素中有统计学意义的因素代入条件Logistic回归模型分析,结果显示,糖尿病、高血压、原肾功能不全、NGAL>120 ng/mL、铁调素>5 ng/mL及CysC>0.5 mg/L为影响CIN发生的危险因素(P<0.05)。ROC曲线显示,(NGAL+铁调素+CysC)三者联合检测的曲线下面积(AUC)、敏感度、特异度分别为0.915、0.952、0.874,明显较各项指标单独检测高(P<0.05)。结论NGAL、铁调素及CysC水平在造影剂使用后24 h可较好地预测CIN,可用于CIN的早期诊断。Objective To analyze the value of neutrophil gelatinase-associated lipocalin(NGAL),hepcidin and Cystatin C(CysC)levels in the early diagnosis of contrast induced nephropathy(CIN). Methods The clinical data of 287 patients who were admitted to Zhengzhou Seventh People’s Hospital from January2020 to September 2021 and used iodine-containing contrast agents for imaging examination were collected,observed the occurrence of CIN,and used a multivariate conditional Logistic regression model to analyze the risk factors affecting the occurrence of CIN. The levels of NGAL,hepcidin and CysC in patients with and without CIN were compared;receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value of the above-mentioned factors for CIN. Results Among the 287 patients,26 had CIN(CIN group)and 261had no CIN(non-CIN group). After angiography,the levels of NGAL,hepcidin,and CysC in the two groups were higher than those before the angiography,and the levels of the above factors in the CIN group were higher than those in the non-CIN group,and the difference was statistically significant(P<0.05). Univariate analysis showed that diabetes,hypertension,prorenal insufficiency,NGAL,hepcidin,and CysC were the single factors affecting the occurrence of CIN(P<0.05). The statistically significant factors in the single factor were substituted into the conditional Logistic regression model for analysis,the results showed that diabetes,hypertension,prorenal insufficiency,NGAL > 120 ng/m L,hepcidin > 5 ng/m L and CysC > 0.5 mg/L were risk factors affecting the occurrence of CIN(P<0.05). The ROC curve showed that the area under curve(AUC),sensitivity,and specificity of the three(NGAL+hepcidin+CysC)combined detection were 0.915,0.952,and0.874,respectively,which were significantly higher than those detected by each indicator alone(P<0.05).Conclusion The levels of NGAL,hepcidin and CysC can better predict CIN at 24 hours after the use of the contrast agent,and can be used for the early diagnosis of CIN.

关 键 词：中性粒细胞明胶酶相关脂质运载蛋白 铁调素 胱抑素C 造影剂肾病 

分 类 号：R692[医药卫生—泌尿科学]