Objective To evaluate the clinical significance of combined detection of Cystatin C (Cys C) ,n-ace-tyl-β-d-glucosaminidase (NAG ) and microalbumin (mALB ) in early diagnosis of contrast induced nephropathy (CIN) .Methods A total of 91 patients with angiography enrolled in this study were divided into CIN group and non-CIN group according to appearance of CIN after angiography 48 h .Cys C ,NAG and mALB were measured before an-giography ,after angiography 12 h ,24 h ,48 h respectively .Results The prevalence of CIN was 13 .2% in all patients registered in this study .The levels of Cys C and NAG in CIN group significantly increased after angiography 12 h , and reached the peak after 24 h and began to decrease after 48 h ,but all were obviously higher than those before in-jection contrast and those in the non-CIN group(P<0 .05) .The level of mALB after contrast injection 24 h began to increased and reached the peak after 48 h in CIN group ,and it were obviously higher than that before injection con-trast and that in the non-CIN group(P<0 .05) .The sensitivity and specificity of combined detection of these 3 inde-xes improved significantly compared with single index detection .Conclusion Combined detection of Cys C ,NAG and mALB play important role in the early diagnosis of CIN .%目的：探讨联合检测胱抑素 C （Cys C ）、尿 N-乙酰-β氨基葡萄糖苷酶（NAG ）及尿微量清蛋白（mALB）在造影剂肾病（CIN）早期诊断中的临床意义。方法选取解放军总医院第一附属医院基础肾功能正常且使用非离子型低渗造影剂进行血管造影的患者91例为研究对象，所有患者分别在造影前24 h ，造影后12、24、48 h抽血检测血清中Cys C、肌酐、尿素氮；尿NAG、mALB及尿蛋白定性。根据患者在造影后48 h内是否发生CIN ，分为CIN组和非CIN组，比较两组各指标情况。结果该研究中CIN的发病率为13．2％。CIN组造影后12 h ，Cys C和尿NAG水平开始升高，24 h达高峰，48 h有所降低，但均高于造影前及非CIN组水平（ P＜0．05）。CIN 组mALB于造影后24 h开始升高，48 h有所下降，均高于造影前及非CIN组水平（P＜0．05）。非CIN组造影前后各时间点Cys C、尿NAG及mALB水平比较，差异无统计学意义（P＞0．05）。同时3项指标联合检测的敏感性和特异性明显高于单项指标检测。结论 Cys C、尿NAG及mALB联合检测在CIN诊断中具有重要的临床意义。
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