【摘要】：目的探討尿中性粒細(xì)胞明膠酶載脂蛋白(NGAL)和腎損傷因子1(KIM-1)在造影劑早期腎損傷中的診斷價(jià)值,評(píng)估水化治療對(duì)造影劑腎病(CIN)的預(yù)防作用。 方法選擇經(jīng)皮冠狀動(dòng)脈介入治療(PCI)患者120例,隨機(jī)分為水化治療組(60例)和對(duì)照組(60例)。PCI術(shù)前6h始給予水化治療組患者靜脈補(bǔ)液至術(shù)后12h。采用自動(dòng)生化儀分別檢測(cè)定患者術(shù)前(TO)、術(shù)后12h (T1)、24h (T2)、48h (T3)、72h (T4)的血Scr、BUN、血漿胱抑素C (Cys-C)及尿微量白蛋白(mAlb)變化,ELISA法檢測(cè)尿NGAL和尿KIM-1水平,檢測(cè)尿al-微球蛋白(a1-MG)、尿N-Z酰一β-D氨基葡萄糖苷酶(NAG)。 結(jié)果(1)120例受試者中有87例患者PCI術(shù)后12h出現(xiàn)尿NGAL/Cr和KIM-1/Cr升高至基線值的兩倍以上,發(fā)生CIN8例6.67%),其中水化治療組l例(1.7%),對(duì)照組7例(11.7%),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)兩組患者血BUN、Scr、mAlb/Cr、Cys-C、GFR的差異無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。(3)兩組患者尿a1-MG、NAG水平均于術(shù)后24h升高。水化治療組術(shù)后72h基本回落至術(shù)前水平,與對(duì)照組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。(4)兩組患者尿NGAL、KIM-1水平均于術(shù)后12h升高。水化治療組術(shù)后72h基本回落至術(shù)前水平,與對(duì)照組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。(5)兩組患者PCI術(shù)后12h NGAL/Cr、KIM-1/Cr的ROC曲線下面積(AUC)分別為0.931、0.811,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論NGAL和KIM-1是診斷造影劑早期腎損傷敏感和特異性的指標(biāo),水化治療可預(yù)防造影劑腎病的發(fā)生。
[Abstract]:Objective to investigate the diagnostic value of urinary neutrophil gelatinase apolipoprotein (NGAL) and renal injury factor-1 (KIM-1) in early renal injury and evaluate the preventive effect of hydration on contrast agent nephropathy (cin). Methods 120 patients with percutaneous coronary intervention (PCI) were randomly divided into hydration group (n = 60) and control group (n = 60). The levels of urinary NGAL and urinary KIM-1 were detected by automatic biochemical instrument before operation (to), 12 h (T1), 48 h (T 3) and 72 h (T 4), plasma cystatin C (Cys-C) and urinary microalbumin (mAlb) were determined by Elisa. Urine al- microglobulin (a1-MG) and urine N-Z acyl-尾-D glucosaminidase (nag) were detected. Results (1) in 87 of 120 subjects, urinary NGAL-Cr and KIM-1 / Cr increased more than twice the baseline value 12 hours after PCI. The incidence of CIN8 was 6.67%, including 1 case (1.7%) in hydration treatment group and 7 cases (11.7%) in control group. There was a significant difference between the two groups (P0.05). (2). There was no significant difference between two groups (P0.05). (3) in urine a1-MGNAG level of two groups (P0.05). (3). The levels of urinary NGALL KIM-1 in hydration treatment group were significantly higher than those in control group (P0.01). (4) at 12 hours after operation. In the hydration treatment group, the area under the ROC curve was 0.931 鹵0.811 at the 12th hour after PCI (P0.01). (5), and there was significant difference between the two groups (P0.05). Conclusion NGAL and KIM-1 are sensitive and specific indexes in the diagnosis of early renal injury in contrast medium. Hydration therapy can prevent the occurrence of contrast agent nephropathy.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 Takaharu ICHIMURA;牟姍;;腎損傷分子1在急性腎損傷與修復(fù)中的作用研究進(jìn)展(英文)[J];中西醫(yī)結(jié)合學(xué)報(bào);2008年05期

2 葉菡洋;袁偉杰;邊琪;梅小斌;傅鵬;郭云珊;崔若蘭;;血管造影術(shù)后腎損害的臨床相關(guān)危險(xiǎn)因素探討[J];中華腎臟病雜志;2006年06期

3 吉俊;丁小強(qiáng);許迅輝;鄒建洲;何建強(qiáng);林貽梅;柏瑾;錢菊英;;低滲非離子造影劑對(duì)冠狀動(dòng)脈介入診療術(shù)患者腎功能影響的前瞻性研究[J];中華腎臟病雜志;2006年07期

，

本文編號(hào)：2120501