Could neutrophil-gelatinase-associated lipocalin and cystatin c predict the development of contrast-induced nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine values?
Could neutrophil-gelatinase-associated lipocalin and cystatin c predict the development of contrast-induced nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine values?
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DOI：
10.1159/000109102
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Dobrzycki, S.
中科院分区：
文献类型：
--
作者：
Bachorzewska-Gajewska, H.;Malyszko, J.;Dobrzycki, S.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）作为一种检测急性肾衰竭的新型生物标志物受到关注。我们对100例血清肌酐值正常且接受经皮冠状动脉介入治疗（PCI）的患者进行了研究，验证NGAL是否可作为对比剂肾病（CIN）的早期生物标志物这一假设。此外，我们还评估了这些患者的血清和尿液NGAL与胱抑素C、估算的肾小球滤过率以及血清和尿液肌酐之间的关系。我们在PCI术前以及术后2、4、8、24和48小时测量尿液和血清NGAL值。我们发现PCI术后2、4和8小时血清NGAL水平显著升高，PCI术后4、8和24小时尿液NGAL值显著升高。胱抑素C在术后24小时显著升高。CIN的患病率为11%。在发生CIN的患者中，PCI术后2小时（血清NGAL）或4小时（尿液NGAL）NGAL水平显著升高，而胱抑素C值仅在PCI术后8和24小时升高。在多变量分析中，PCI术前只有血清肌酐是血清NGAL的预测因子。NGAL可能是PCI术后肾功能损害的敏感早期生物标志物。血清肌酐水平、糖尿病的存在以及PCI的持续时间可能影响PCI术后的血清NGAL值和肾功能。
The value of neutrophil-gelatinase-associated lipocalin ( NGAL) was highlighted as a novel biomarker for the detection of acute renal failure. We tested the hypothesis whether NGAL could represent an early biomarker of contrast-induced nephropathy (CIN) in 100 patients with normal serum creatinine values undergoing percutaneous coronary interventions (PCI). In addition, we assessed serum and urinary NGAL in relation to cystatin C, estimated glomerular filtration rate, and serum and urinary creatinine in these patients. We measured urinary and serum NGAL values before and 2, 4, 8, 24, and 48 h after the PCI. We found a significant rise in serum NGAL levels 2, 4, and 8 h after the PCI and in urinary NGAL values 4, 8, and 24 h after a PCI procedure. Cystatin C rose significantly 24 h after the procedure. The prevalence of CIN was 11%. The NGAL levels were significantly higher 2 h after the PCI ( serum NGAL) or 4 h after the PCI ( urinary NGAL), whereas the cystatin C values were higher only 8 and 24 h after a PCI procedure in patients with CIN. In multivariate analysis, only serum creatinine was a predictor of serum NGAL before a PCI. NGAL may represent a sensitive early bio-marker of renal impairment after PCI. Serum creatinine level, the presence of diabetes, and the duration of the PCI may affect serum NGAL values and kidney function following a PCI procedure.