CAJ | 학술논문

目的：探讨不同对比剂对冠心病介入治疗术后患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及β2-微球蛋白(β2-MG)的影响。方法选取2015年1~6月于潍坊市益都中心医院心内科住院并行经皮冠状动脉介入治疗(PCI)的83例冠心病患者,将其随机分为等渗对比剂组(n=45)和低渗对比剂组(n=38)。分别于PCI术前及术后6、12、24、72 h留取尿液标本,通过酶联免疫吸附法(ELISA)检测尿NGAL和β2-MG的浓度。结果两组患者术后尿NGAL/CR比值较术前显著升高(P<0.01),低渗对比剂组较等渗对比剂组升高更为明显(P<0.01)；两组患者尿β2-MG/CR比值于术后12 h开始升高(P<0.05),24 h、72 h较术前显著升高(P<0.01),组间术后24 h的β2-MG/CR比值比较差异有统计学意义(P<0.05)。结论在PCI术中应用低渗对比剂对尿NGAL/CR、β2-MG/CR影响显著高于等渗对比剂,相对于等渗对比剂,低渗对比剂对PCI患者术后肾小管功能的损伤更为严重。
목적：탐토불동대비제대관심병개입치료술후환자뇨중성립세포명효매상관지질운재단백(NGAL)급β2-미구단백(β2-MG)적영향。방법선취2015년1~6월우유방시익도중심의원심내과주원병행경피관상동맥개입치료(PCI)적83례관심병환자,장기수궤분위등삼대비제조(n=45)화저삼대비제조(n=38)。분별우PCI술전급술후6、12、24、72 h류취뇨액표본,통과매련면역흡부법(ELISA)검측뇨NGAL화β2-MG적농도。결과량조환자술후뇨NGAL/CR비치교술전현저승고(P<0.01),저삼대비제조교등삼대비제조승고경위명현(P<0.01)；량조환자뇨β2-MG/CR비치우술후12 h개시승고(P<0.05),24 h、72 h교술전현저승고(P<0.01),조간술후24 h적β2-MG/CR비치비교차이유통계학의의(P<0.05)。결론재PCI술중응용저삼대비제대뇨NGAL/CR、β2-MG/CR영향현저고우등삼대비제,상대우등삼대비제,저삼대비제대PCI환자술후신소관공능적손상경위엄중。
Objective To probe the influence of different contrast agents on neutrophil gelatinase-associated lipocalin (NGAL)andβ2-microglobulin(β2-MG) in patients with coronary atherosclerotic heart disease after coronary intervention-al treatment. Methods From January to June 2015,83 patients who were diagnosed with coronary artery disease to un-dergo percutaneous coronary intervention(PCI)in Yidu central hospital of weifang were enrolled.They were randomly di-vided into two groups including an isotonic contrast group (n=45)and a hypotonic contrast group (n=38).The levels of urine NGAL andβ2-MG were assessed before PCI and at 6,12,24 and 72 h after PCI by enzyme-linked immunospecif-ic assay (ELISA). Results The ratio of urine NGAL/CR was significantly increased after PCI between two groups (P<0.01).Compared with isotonic contrast group,the ratio of hypotonic contrast group increased obviously (P<0.01).Between two groups,the ratio of urineβ2-MG/CR began to rise after 12 h(P<0.05),with obviously increased at 24 h and 72 h af-ter PCI compared with before PCI(P<0.01).There were statistically differences at 24 h after PCI between two groups(P<0.05). Conclusion The effect of hypotonic contrast agent on urinary NGAL/CR and β2-MG/CR is significantly higher than isotonic contrast agent in PCI.With respect to the isotonic contrast agent,hypotonic contrast agent may have more severe injuries on renal tubular function in patients after PCI.