【摘要】：目的 研究中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白(Neutrophil Gelatinase-AssociatedLipocalin, NGAL)、白細(xì)胞介素-18（Interleukin-18, IL-18）、半胱氨酸蛋白酶抑制C（cystatinC, CysC）等腎臟損傷的生物學(xué)指標(biāo)在冠狀動(dòng)脈造影（Coronary angiograph,CAG）介入（percutaneous coronary intervention, PCI）術(shù)后的變化及對(duì)對(duì)比劑腎病(Contrast Induced Nephropathy, CIN)早期診斷的臨床預(yù)測(cè)價(jià)值。 方法 選取我院2012年5月～2014年1月期間180例行冠狀動(dòng)脈造影介入術(shù)治療的患者為研究對(duì)象，，檢測(cè)術(shù)前、術(shù)后1天、2天、3天血SCr、血CysC、尿IL-18和尿NGAL的水平。發(fā)生CIN的病例(以冠狀動(dòng)脈術(shù)后48h的血清肌酐（SCr）≥44.2mmol/L或升高≥25%為診斷標(biāo)準(zhǔn))判為CIN組,未發(fā)生CIN的病例判為非CIN組。 結(jié)果 1180例行冠狀動(dòng)脈造影介入術(shù)治療的患者中出現(xiàn)13例CIN患者，CIN的發(fā)生率為7.2%。 2術(shù)后第1天尿NGAL水平達(dá)到高峰,較術(shù)前基線水平顯著升高(P0.05)。 3術(shù)后第2天尿IL-18水平達(dá)到高峰,同基礎(chǔ)水平相比有顯著差異(P0.05)。 4血CysC水平無(wú)明顯性變化(P0.05)。 5尿NAGL, IL-18在ROC曲線下的面積分別為0.902、0.763，敏感性分別為79%、64%，特異性分別為58%、82%。 結(jié)論 1.尿NGAL是早期診斷急性腎損傷(AKI)的一種敏感的標(biāo)志物。 2.尿IL-18在早期預(yù)測(cè)CIN中也具有一定的診斷價(jià)值。 3.尿NGAL較尿IL-18在預(yù)測(cè)CIN更加敏感，但NGAL單獨(dú)診斷CIN受到許多潛在因素的干擾（如交叉反應(yīng)物、內(nèi)源性物質(zhì)等）。
[Abstract]:Objective to study the effects of neutrophil gelatinase-associated lipid carrier protein (Neutrophil Gelatinase-AssociatedLipocalin, NGAL), Interleukin-18, IL-18) and cysteine protease on the inhibition of renal injury such as C (cystatinC, CysC) by coronary artery angiography (Coronary angiograph,CAG) interventional (percutaneous coronary Changes after intervention, PCI) and clinical predictive value for early diagnosis of (Contrast Induced Nephropathy, CIN) in contrast nephropathy. Methods from May 2012 to January 2014, 180 patients underwent coronary angiographic interventional therapy in our hospital were selected as study subjects. The levels of serum CysC, urine IL-18 and urinary NGAL were measured before and 2 days after operation and 3 days after operation. The patients with CIN (serum creatinine (SCr) 鈮

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