Neutrophil-gelatinase-associated lipocalin and renal function after percutaneous coronary interventions
Neutrophil-gelatinase-associated lipocalin and renal function after percutaneous coronary interventions
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DOI：
10.1159/000093961
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发表时间：
2006-01-01
影响因子：
4.2
通讯作者：
Dobrzycki, S.
中科院分区：
文献类型：
--
作者：
Bachorzewska-Gajewska, H.;Malyszko, J.;Dobrzycki, S.
背景/目的：中性粒细胞-明胶酶相关脂钙蛋白（NGAL）是一种新的生物标志物，在检测儿童心脏手术后急性肾功能衰竭方面的价值已在以往的研究中得到强调。经皮冠状动脉介入治疗（PCI）的发生率增加，这可能导致造影剂肾病的发生率增加，其潜在的严重并发症。因此，我们研究的目的是前瞻性地评估选择性PCI患者NGAL与血清肌酐的关系。方法：采用市售试剂盒检测血清和尿液中NGAL的含量。结果：分别于PCI术前、术后2、4、12、24、48 h测定尿和血清NGAL。我们发现PCI后血清NGAL 2和4小时显著升高，PCI后尿NGAL 4和12小时显著升高。PCI前，血清NGAL与血清肌酐、尿素、尿NGAL、血红蛋白、红细胞压积、白蛋白、年龄和糖尿病存在显著相关。在多变量分析中，血清肌酐是血清NGAL的唯一预测因子。PCI术后2 h血清NGAL与血清肌酐、PCI持续时间、HbA1c、红细胞压积、血红蛋白、尿NGAL相关。在多因素分析中，预测PCI术后2 h血清NGAL的指标只有血清肌酐、PCI时间和HbA1c。糖尿病患者PCI术前血清NGAL水平明显高于非糖尿病患者。结论：NGAL可能是PCI术后肾脏损害的一个敏感的早期生物标志物。血清肌酐，PCI持续时间，而不是对比剂的类型和量，以及糖尿病的适当治疗，通过HbA1c反映，预测PCI后血清NGAL和肾功能的升高。版权所有(c) 2006 S. Karger AG，巴塞尔。
Background/Aims: The value of neutrophil-gelatinase-associated lipocalin (NGAL), a novel biomarker in the detection of acute renal failure in children after cardiac surgery, has been highlighted in previous studies. The incidence of percutaneous coronary intervention (PCI) increases, which may possibly result in increased incidences of contrast nephropathy, its potentially serious complication. Therefore, the aim of our study was to assess prospectively NGAL in patients undergoing elective PCI in relation to serum creatinine. Methods: NGAL was assessed in the serum and urine using commercially available kits. Results: We measured urinary and serum NGAL before, and 2, 4, 12, 24 and 48 h after PCI. We found a significant rise in serum NGAL 2 and 4 h after PCI, and a rise in urinary NGAL 4 and 12 h after PCI. Before PCI, serum NGAL was significantly associated with serum creatinine, urea, urinary NGAL, hemoglobin, hematocrit, albumin, age and presence of diabetes. In multivariate analysis, serum creatinine was the only predictor of serum NGAL. Serum NGAL 2 h after PCI correlated with serum creatinine, duration of PCI, HbA1c, hematocrit, hemoglobin and urinary NGAL. In multivariate analysis, the only predictors of serum NGAL 2 h after PCI were serum creatinine, time of PCI and HbA1c. Serum NGAL before PCI was significantly higher in diabetics than in non-diabetics. Conclusions: NGAL may represent a sensitive early biomarker of renal impairment after PCI. Serum creatinine, duration of PCI, but not type and amount of contrast agent, and appropriate treatment of diabetes, reflected by HbA1c, predict a rise in serum NGAL and kidney function following PCI. Copyright (c) 2006 S. Karger AG, Basel.