Plasma neutrophil gelatinase-associated lipocalin (NGAL) and plasma cystatin C (CysC) as biomarker of acute kidney injury after cardiac surgery
Plasma neutrophil gelatinase-associated lipocalin (NGAL) and plasma cystatin C (CysC) as biomarker of acute kidney injury after cardiac surgery
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DOI：
10.4103/1319-2442.132194
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发表时间：
2014-05-01
影响因子：
0.5
通讯作者：
Amro, Ghada M.
中科院分区：
文献类型：
--
作者：
Ghonemy, Tarek A.;Amro, Ghada M.
急性肾损伤（阿基）是一种常见的严重疾病，经常发生在心肺转流术和其他心脏手术后。这项工作的目的是评估新的肾损伤标志物，血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和血浆半胱氨酸蛋白酶抑制剂C（CysC）作为心脏手术后阿基的早期预测因子的效用。本研究招募了50名心脏病患者，并将他们分为两组，每组25名患者。I组患者行冠状动脉旁路移植术（CABG），II组患者行瓣膜置换术。采用酶联免疫吸附法（ELISA）测定血浆CysC和NGAL水平。阿基患者的血浆NGAL测量显示在手术后3和6小时从其基础水平高度显著升高（P < 0.001）。阿基患者术后6 h血浆CysC水平较基础水平显著升高（P < 0.05）。与无阿基患者相比，阿基患者心脏手术后24 h血浆NGAL和CysC在统计学上高度显著增加（P < 0.001）。术后3 h NGAL的敏感性和特异性分别为94.1%和93.9%，而血浆CysC的敏感性和特异性分别为54.7%和72.7%。术后6 h，NGAL敏感性上升至98.1%，特异性略有下降至91.9%，而CysC敏感性和特异性分别上升至75.2%和75.8%。总之，血浆NGAL和血浆CysC可以被认为是心肺转流术后阿基的早期预测因子。
Acute kidney injury (AKI) is a common and serious condition that frequently occurs after cardiopulmonary bypass and other cardiac surgeries. The objective of this work is to evaluate the utility of new markers for kidney damage, plasma neutrophil gelatinase-associated lipocalin (NGAL) and plasma cystatin C (CysC) as early predictors of AKI after cardiac surgery. Fifty cardiac patients were recruited for this study, and they were divided into two groups of 25 patients each. Group I patients underwent coronary artery bypass graft (CABG) operation and Group II patients underwent valve replacement operation. Blood sample was taken for measurement of plasma CysC and NGAL by enzyme-linked immunosorbent assay. Plasma NGAL measurement in patients with AKI shows a highly significant rise at 3 and 6 h after surgery from its basal level (P < 0.001). Plasma CysC measurement in patients with AKI is significantly higher at 6 h after surgery from its basal level (P < 0.05). A statistically highly significant increase in plasma NGAL and CysC at 24 h after cardiac surgery in patients with AKI compared with patients without AKI (P < 0.001). The sensitivity and specificity of NGAL at 3 h post-operative was 94.1% and 93.9% respectively, while plasma CysC sensitivity and specificity was 54.7% and 72.7%, respectively. After 6 h post-operative, NGAL sensitivity increased to 98.1% with slight decrease of the specificity to 91.9%, while CysC sensitivity and specificity increased to 75.2% and 75.8%, respectively. In conclusion, plasma NGAL and plasma CysC may be considered as early predictors of AKI after cardio-pulmonary bypass operations.