摘要
目的通过监测老年患者造影前后血清肌酐(Scr)及血清胱抑素C(CysC)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1)的变化,评估造影剂对老年患者肾脏功能的影响。方法收集接受血管造影检查的年龄≥60岁患者的相关资料共62例。用酶法测定患者造影前及造影后24 h,48 h,72 h Scr值。用酶联免疫吸附剂测定法检测患者造影前及造影后24 h、48 h、72 h血清CysC、NGAL及尿液KIM-1数值,进行造影前后的对比分析。结果依照造影剂肾病(CIN)的诊断标准,入选患者中2例发生CIN,患病率为3.23%。Scr水平在造影前后未见明显改变,CysC、NGAL、KIM-1水平在造影后的不同时间段较造影前水平显著升高(P<0.05),而72 h后均逐渐恢复至造影前水平。e GFR 45~60 ml/(min·1.73m^2)的患者造影后的血清CysC、NGAL,及尿KIM-1上升幅度均不同程度地高于eG FR≥60 ml/(min·1.73m^2)的患者,但72 h后两组数值均基本恢复至造影前水平。结论基础肾脏功能正常或轻中度损害的老年患者注射造影剂后,除Scr外,各项肾损伤标志物均呈现72 h内升高,后恢复至基线水平的动态变化,变化幅度与基础肾功能相关。
Objective To assess the effect of contrast media on renal function in elderly patients by monitoring the changes of serum creatinine（ Scr）,serum cystatin C（ CysC）,neutrophil gelatinase-associated lipocalin（ NGAL） and kidney injury molecule 1（ KIM-1） levels before and after angiography. Methods Sixty-two patients who were over sixty years old were enrolled in this study. Before and 24 h,48h and 72 h after angiography,Scr was tested by enzymic method,serum CysC,serum NGAL,and urine KIM-1 were detected by enzyme linked immunosorbent assay（ ELISA）. The levels of the biomarkers obtained from different time points were compared and analyzed. Results Contrast-induced nephropathy（ CIN） occurred in 2 of 62 enrolled patients（ 3. 23%）. Before and after angiography,the level of Scr had no significant change; the levels of CysC,NGAL and KIM-1 elevated significantly after the angiography（ P〈0. 05）,and returned to baseline after 72 h. After angiography,the levels of serum Cys C,serum NGAL and urine KIM-1 elevated more obvious in the patients with estimated glomerular filtration rate（ e GFR） 45 ~ 60 ml /（ min·1. 73 m^2）,than the patients with e GFR ≥60 ml/（ min·1. 73 m^2）,although all of them returned to baseline after 72 h.Conclusion After angiography in elderly patients with normal or mild-to-moderate injured renal function,all levels of kidney injury biomarkers except Scr elevated and then returned to baseline within 72 h,and the amplitude of variation was related to the basic renal function.
出处
《临床和实验医学杂志》
2016年第3期296-299,共4页
Journal of Clinical and Experimental Medicine
关键词
老年人
造影剂
肾损伤标志物
Elderly patients
Contrast agent
Kidney injury biomarkers
