Combined evaluation of plasma B-type natriuretic peptide and urinary liver-type fatty acid-binding protein/creatinine ratio is related to worsening renal function in patients undergoing elective percutaneous coronary intervention
Combined evaluation of plasma B-type natriuretic peptide and urinary liver-type fatty acid-binding protein/creatinine ratio is related to worsening renal function in patients undergoing elective percutaneous coronary intervention
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血浆B型利钠肽和尿肝型脂肪酸结合蛋白/肌酐比值联合评价与择期经皮冠状动脉介入治疗患者肾功能恶化的相关性
DOI：
10.1007/s10157-021-02113-9
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发表时间：
2021
影响因子：
2.3
通讯作者：
Yasuda Satoshi
中科院分区：
文献类型：
--
作者：
Yoshihara Fumiki;Hosoda Hiroshi;Doi Takahito;Yoshida Morikatsu;Kitamura Kazuo;Yamamoto Haruko;Asaumi Yasuhide;Ishibashi-Ueda Hatsue;Kishida Masatsugu;Arisato Tetsuya;Matsuo Miki;Miyazato Mikiya;Yasuda Satoshi
背景目前关于血液体液因子和尿生物标志物联合评价冠状动脉造影（CAG）/经皮冠状动脉介入治疗（PCI）后肾功能恶化（WRF）的意义的报道较少。方法和结果尿肝型脂肪酸结合蛋白（L-FABP）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、分别于术前24 h内、术后3 h、6 h、1 d、2 d测定血浆肾上腺髓质素（AM）水平。WRF定义为估计的GFR降低> 20%。100例患者中有7例发生WRF，WRF组在CAG/PCI后1天的L-FABP/肌酐（Cr）升高显著高于非WRF组。CAG/PCI前血浆B型利钠肽（BNP）和CAG/PCI后第1天L-FABP/Cr是WRF的独立预测因子。接受者工作特征曲线下的面积如下：CAG/PCI前BNP为0.760，CAG/PCI后第1天L-FABP/Cr为0.731，BNP和L-FABP/Cr为0.892。PCI/CAG后尿AM水平仅与血清钾水平呈负相关。肾小管上皮细胞AM及AM受体基因表达阳性。AM增加细胞内的第二信使水平在一个剂量依赖martens.ConclusionsOur结果表明，血浆BNP和尿L-FABP/Cr的联合评价是有用的，作为一个预测肾功能不全的CAG/PCI患者。
BackgroundThere are few reports on the significance for the combined evaluation of blood humoral factors and urinary biomarkers in terms of worsening renal function (WRF) after coronary angiography (CAG)/percutaneous coronary arterial intervention (PCI).Method and resultsUrinary liver type-fatty acid-binding protein (L-FABP), neutrophil gelatinase associated lipocalin (NGAL), and adrenomedullin (AM) were measured less than 24 h before and 3 h, 6 h, 1 day, and 2 days after CAG/PCI. WRF was defined as a > 20% decrease in the estimated GFR. WRF occurred in seven of 100 patients and the increase in L-FABP/creatinine (Cr) at 1 day after CAG/PCI was significantly higher in the WRF group than in the non-WRF group. Plasma B-type natriuretic peptide (BNP) before CAG/PCI and L-FABP/Cr at 1 day after CAG/PCI were independent predictors for WRF. The areas under the receiver-operating characteristic curves were as follows: 0.760 for BNP before CAG/PCI, 0.731 for L-FABP/Cr at 1 day after CAG/PCI, and 0.892 for BNP and L-FABP/Cr. Urinary AM levels after PCI/CAG were negatively correlated only to serum potassium levels. Gene expressions of AM and AM-receptor were detectable in renal tubule epithelial cells. AM increased intracellular second messenger levels in a dose-dependent manner.ConclusionsOur results suggest that combined evaluation of plasma BNP and urinary L-FABP/Cr is useful as a predictor of renal dysfunction in CAG/PCI patients.
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