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目的用受试者特征工作曲线(ROC曲线)评价尿液中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil gelati-nase-associated lipocalin,NGAL)水平在诊断对比剂肾病(Contrast-induced Nephropathy,C IN)的早期临床应用价值。方法收集行CAG和/或PC I的患者195例,所有患者术前及术后24 h、48 h进行血肌酐(Scr)检测,并于术前和术后2 h、6h、12 h、24 h、48 h留取尿液测定NGAL水平。通过分析ROC曲线评价它们对C IN早期诊断价值。结果①诊断为C IN的患者术后12 h、24 h、48 h尿NGAL的浓度与术前比较,差异有统计学意义(P<0.05),而术后24 h Scr与术前比较差异无统计学意义,尿NGAL较Scr提前至少24 h诊断C IN。②术后12 h尿NGAL的ROC曲线下面积为0.836,AUC 95%的可信区间为(0.747,0.906)。据此预测C IN的临界点为62.55 ng/m l,灵敏度为81.4%,特异度为75.8%。术后24 hROC曲线下的面积为0.804,AUC 95%的可信区间为(0.693,0.916)。据此预测C IN的临界点为80.79 ng/m l,灵敏度为80%,特异度为65.6%。结论 NGAL是反映C IN患者早期肾损害的良好指标,而且早于血Scr。
Objective To evaluate the value of urinary neutrophil gelati-nase-associated lipocalin (NGAL) in the diagnosis of contrast-induced nephropathy (C) by using receiver operating characteristic curve (ROC curve) IN) early clinical value. Methods A total of 195 patients with CAG and / or PC I were collected. Serum creatinine (Scr) was detected in all patients before and 24 h and 48 h after operation. h, 48 h urine to determine the level of NGAL. Their R & D values for early detection of C IN were evaluated by analysis of ROC curves. Results ① The urinary NGAL concentrations at 12 h, 24 h and 48 h after operation in patients with C IN were significantly different from those before operation (P <0.05), but no significant differences between the two groups at 24 h after operation Statistical significance, urinary NGAL compared with Scr at least 24 h diagnosis of CIN. ② The area under the ROC curve of urine NGAL 12 h after operation was 0.836, and the confidence interval of AUC 95% was (0.747, 0.906). The critical point for C IN was predicted to be 62.55 ng / ml, with a sensitivity of 81.4% and a specificity of 75.8%. The area under the ROC curve at 24 h after surgery was 0.804, and the confidence interval for AUC 95% was (0.693, 0.916). The critical point for C IN was predicted to be 80.79 ng / ml, with a sensitivity of 80% and a specificity of 65.6%. Conclusion NGAL is a good indicator of early renal damage in patients with CIN, and earlier than blood Scr.