血浆中性粒细胞明胶酶相关脂质运载蛋白对住院心力衰竭患者肾功能的预测

摘要

Objective To explore the prognostic value of baseline plasma neutrophil gelatinase-associated the lipocalin(NGAL) for worsening renal function in heart failure (HF).Methods We consecutively enrolled 396 patients hospitalized with HF and used chronic kidney disease epidemiology collaboration (CKD-EPI) formula to calculate estimated glomerular filtration rate (eGFR).All patients were divided into 2 groups:cardiorenal syndrome (CRS) group [eGFR ＜ 60 ml/(min · 1.73 m2),n =97] and non-CRS group [eGFR ≥ 60 ml/(min · 1.73 m2),n =299],indicators measuring the concentration of NGAL two groups of patients,N-terminal pro-brain natriuretic peptide (NT-proBNP),creatinine,serum urea nitrogen (BUN).Results In correlation analysis,r value between NGAL and NT-proBNP,creatine,BUN was 0.194,0.527,and 0.433,respectively (P ＜0.01).The area under the receiver operating characteristic (ROC) curve of NGAL,NT-proBNP,BUN to evaluate worsening renal function was 0.863,0.681,and 0.828,respectively (P ＜0.01).Conclusions Plasma NGAL was an independent worsening renal function predictor for hospitalized patients with heart failure.%目的 探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对住院心力衰竭(简称心衰)患者肾功能的预测价值.方法 连续入选396例因心衰住院的患者,根据慢性肾脏病流行病学合作研究公式(CKD-EPI)计算肾小球滤过率(eGFR),将入选患者分为心肾综合征(CRS)组[eGFR＜60 ml/(min·1.73 m2),凡=97]和非CRS组[eGFR≥60 ml/(min·1.73 m2),n=299],测定两组患者NGAL、N末端B型利钠肽原(NT-proBNP)、肌酐、尿素氮等指标浓度.结果 CRS组NGAL、NT-proBNP水平均明显高于非CRS组(P＜0.01).NGAL与NT-ProBNP、肌酐、尿素氮呈正相关(r=0.194、0.527、0.433,P＜0.01).NGAL及NT-ProBNP、尿素氮预测住院心衰患者肾功能恶化ROC曲线下面积分别为0.863、0.681、0.828(P＜0.01).结论 血浆NGAL对住院心衰患者肾功能恶化具有独立预测的作用.