Objective To investigate the value of combined detection of serum neutrophil gelationase associated lipocalin(NGAL)and Cystatin C (Cys-C)in predicting the contrast induced nephropathy (CIN)after percutaneous coronary intervention.Methods A total of 114 patients with suspected coronary heart disease underwent PCI were included.The patients were divided into two groups:CIN (12 cases)and non-CIN (102 cases).The level of SCr, CysC and NGAL were measured before and after operation.The area under receiver operating characteristic curve (AUC)was used to assess the sensitivity of NGAL and Cys-C in early diagnosis of CIN.Results The serum NGAL of CIN was significantly higher than that of non-CIN at 6 hours after operation(P =0.01).The serum Cys-C of CIN was significantly higher than that of non-CIN at 12 hours after operation (P <0.01).The serum NGAL and Cys-C of CIN were significantly higher than those of non-CIN at 12 hours,24 hours,48 hours after operation(P <0.01).However, the serum SCr and Cys-C of CIN were not significantly higher than those of non-CIN at 6 hours after operation(P =0.46,P =0.67).The area under receiver operating characteristic curve (AUC)of NGAL,Cys-C and SCr were 0.81, 0.75 and 0.57 at 6 hours after operation.The AUC of NGAL,Cys-C and SCr were 0.89,0.83 and 0.8 at 12 hours after operation.The AUC of NGAL,Cys-C and SCr were 0.88,0.86 and 0.85 at 24 hours after operation.The AUC of NGAL,Cys-C and SCr were 0.77,0.7 and 0.88 at 48 hours after operation.Conclusion For patients with coronary heart disease after PCI,serum NGAL and Cys-C levels can early reflect the kidney function and give an early prediction of CIN.%目的 观察经皮冠状动脉介入治疗(PCI)术后血清中性粒细胞明胶酶相关脂质转运蛋白(NGAL)和胱抑素C(Cys-C)水平变化,探讨二者在造影剂肾病(CIN)早期诊断中的价值.方法 选择冠心病支架置入术患者114例,以术后发生CIN患者12例为CIN组,以未发生CIN患者102例为非CIN组,测定两组患者手术前后血肌酐(SCr)、Cys-C、NGAL水平,并通过ROC曲线下面积(AUC)评估血清NGAL及Cys-C对早期CIN诊断的敏感度.结果 CIN组血清NGAL在术后6小时开始上升(P=0.01),CIN组血清Cys-C在术后12小时开始上升(P<0.01).CIN组术后12小时、24小时及48小时血NGAL和Cys-C高于非CIN组,差异有统计学意义(P<0.01),但CIN组术后6小时SCr及Cys-C水平不高于非CIN组,差异无统计学意义(P=0.46,P=0.67).术后6小时NGAL、Cys-C及SCr的AUC分别为0.81,0.75,0.57;术后12小时NGAL、Cys-C及SCr的AUC分别为0.89,0.83,0.8;术后24小时NGAL、Cys-C及SCr的AUC分别为0.88,0.86,0.85;术后48小时NGAL、Cys-C及SCr的AUC分别为0.77,0.7,0.88.结论 冠心病支架置入术患者术后血清NGAL、Cys-C水平能较早反应肾功能变化,为CIN的早期诊断提供一定依据.
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