目的研究慢性心力衰竭患者血清和尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平与心、肾功能的关系,探讨其临床意义。方法慢性心力衰竭150例,测定其血NGAL、尿NGAL、血肌酐、清蛋白、半胱氨酸蛋白酶抑制物C、血常规、左心室射血分数、左心室舒张末内径、肾小球滤过率(GFR),并进行相关性分析。结果NYHA class Ⅲ组血NGAL值较NYHA class Ⅰ组比较差异有统计学意义(P〈0.05),NYHA class Ⅲ组和NYHA class Ⅱ组尿NGAL测定值较NYHA class Ⅰ组比较差异有统计学意义(P〈0.01)。血NGAL与血Cr、NYHA分级、收缩压、舒张压、血cystatin C正相关,与血Alb、GFR负相关;尿NGAL与血Cr正相关,与Ccr负相关。结论无原发性肾脏病变的慢性心力衰竭患者存在早期的肾功能异常,NGAL是反映慢性心力衰竭患者早期肾功能损伤的敏感指标。
Objective To investigate the clinical signification of neutrophil gelatinase-associated lipocalin (NGAL) for renal function evaluation in patients with chronic heart failure. Methods The study was performed on 150 patients with chronic heart failure. Serum and urinary NGAL as well as serum creatinine, albumin, cystatin C, blood routine, LVIDd, ejection fraction and GFR were measured. Results The Serum NGAL of patients in NYHA class Ⅲ was significantly higher than that of patients in NYHA class Ⅰ (P〈0.05). The urinary NGAL of patients both in NYHA class Ⅲ and NYHA class Ⅱ were significantly higher than that of patients in NYHA class Ⅰ (P〈0.01). In addition, serum NGAL was related to serum creatinine, NYHA class, albumin,Systolic BP,Diastolic BP,GFR, cystatin C. Urinary NGAL correlated with serum creatinine and Creatinine clearance. Conclusion NGAL should be investigated as a potential early and sensitive marker of kidney injury.