CAJ | 학술논문

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil gelatinase-associated lipocalin,NGAL)在体外循环术后急性肾损伤(Acute kidney injury,AKI)早期诊断中的价值与意义.方法选择120例进行体外循环手术的先天性心脏病患者,体外循环结束后第一个12 h内每2小时采集尿样及血样1次,此后3 d内每12小时采集1次,采用ELISA方法对尿样中NGAL进行定量分析,同时在相应时间点检测血清肌酐水平,血清肌酐比基线水平增加50%以上为发生AKI的标准.结果术后3 d内有21例发生不同程度AKI,发生率17.5%,AKI组尿NGAL在体外循环术后2 h即显著上升,以术后2～6 h最为显著,而血清肌酐多数在体外循环术后24 h才开始上升,AKI组与无AKI组血肌酐差异有统计学意义(P＜0.05),ROC分析表明术后2 h的尿NGAL在Cutoff值为100 ng/mg Cr时,其诊断AKI的敏感性和特异性分别为92%和91%.结论尿NGAL可以作为体外循环术后AKI早期诊断的预测指标.
목적 탐토뇨중성립세포명효매상관지질운재단백(Neutrophil gelatinase-associated lipocalin,NGAL)재체외순배술후급성신손상(Acute kidney injury,AKI)조기진단중적개치여의의.방법 선택120례진행체외순배수술적선천성심장병환자,체외순배결속후제일개12 h내매2소시채집뇨양급혈양1차,차후3 d내매12소시채집1차,채용ELISA방법대뇨양중NGAL진행정량분석,동시재상응시간점검측혈청기항수평,혈청기항비기선수평증가50%이상위발생AKI적표준.결과 술후3 d내유21례발생불동정도AKI,발생솔17.5%,AKI조뇨NGAL재체외순배술후2 h즉현저상승,이술후2～6 h최위현저,이혈청기항다수재체외순배술후24 h재개시상승,AKI조여무AKI조혈기항차이유통계학의의(P＜0.05),ROC분석표명술후2 h적뇨NGAL재Cutoff치위100 ng/mg Cr시,기진단AKI적민감성화특이성분별위92%화91%.결론 뇨NGAL가이작위체외순배술후AKI조기진단적예측지표.
Objective To evaluate the value of neutrophil gelatinase - associated lipocalin (NGAL) for diagnosis of acute kidney injury (AKI) after cardiopulmonary bypass established. Method 120 children undergoing cardiopulmonary bypass were enrolled in this prospectively study. Serial urine samples were analyzed by ELISA for NGAL expression. The primary outcome measure was AKI, which was defined as a 50% or greater increase in serum creatinine from baseline. Result 21 children ( 17.5% ) developed AKI. Urine concentrations of NGAL increased after cardiopulmonary bypass had been established for 2 hours. The concentration of NGAL in urine after cardiopulmonary bypass had been established for 2 hours was used to diagnose AKI. The area under the receiver-operating characteristic curve was 0. 96, the sensitivity was 92%, and the specificity was 91% for the cutoff value of 100ng/mg Cr. Conclusion Concentrations of NGAL in urine might be used as a sensitive and specific biomarker for early prediction of AKI after cardiopulmonary bypass had been established.