Predictive Value of Neutrophil Gelatinase-associated Apolipoprotein on Contrast Induced Nephropathy in Patients After Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2018.04.004
- VernacularTitle:中性粒细胞明胶酶相关载脂蛋白对经皮冠状动脉介入治疗术后造影剂肾病的预测研究
- Author:
Xiao-Jin XU
1
;
Qing ZHANG
;
Bing-Jian WANG
;
Hai-Lang LIU
;
Shu-Ren MA
Author Information
1. 南京医科大学附属淮安第一医院 心内科
- Keywords:
Contrast induced nephropathy;
Percutaneous coronary intervention;
Neutrophil gelatinase- associated apolipoprotein
- From:
Chinese Circulation Journal
2018;33(4):327-331
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To investigate the early diagnostic value of neutrophil gelatinase-associated apolipoprotein (NGAL) on contrast induced nephropathy (CIN) in patients after percutaneous coronary intervention (PCI). Methods: A total of 200 patients received coronary angiography (CAG) and PCI in our hospital from 2016-01 to 2017-02 were enrolled and the research included in 2 groups: CIN group, 23 and Non-NCI group, according to 4:1 ratio, 92 patients without NCI. Serum levels of creatinine, blood and urine levels of NGAL were examined and compared at pre-operation and 4 h, 24 h, 48 h and 72 h after the operation between 2 groups. Results: All patients received CAG and CIN occurred in 23/200 (11.5%) patients. Compared with Non-CIN group, CIN group had more patients with elder age, more smokers and diabetes, P<0.05. Pre-operative blood and urine NGAL were both at normal level and it was similar between 2 groups, P>0.05. In CIN group, urine NGAL was significantly increasing at 4 h after operation and gradually increasing to 72 h after operation; blood NGAL was significantly increasing at 4 h after operation, it began decreasing at 24 h after operation and remained a relatively high level at 72 h after operation; post-operative blood and urine levels of NGAL were different from pre-operative condition at each time points, all P<0.05. In Non-CIN group, post-operative blood and urine levels of NGAL were similar to pre-operative condition, P>0.05. Post-operative blood and urine NGAL were different at the same time point between 2 groups, P<0.01. AUC of ROC for post-operative urine NGAL at 4h, 24h, 48h and 72h were 0.908, 0.926, 0.931 and 0.957 respectively, the sensitivity and specificity for CIN diagnosis were 91.3% and 100% at 4 time points; AUC of ROC for post-operative blood NGAL at 4 h and 24 h were 0.964 and 0.913, the sensitivity and specificity for CIN diagnosis were 87.3% and 100% at both time points. Conclusions: Blood and urine levels of NGAL may reflect renal function changes earlier than serum creatinine in CAG/PCI patients, it had the higher sensitivity and specificity for CIN diagnosis and could be used as the early predictor for CIN occurrence.
