摘要
目的检验血清中性粒细胞明胶酶相关脂质沉积蛋白(NGAL)是否可以预测Stanford A型主动脉夹层(TAAD)行全主动脉弓置换术后急性肾损伤(AKI)的发生。方法前瞻性收集西京医院2018年10月至2019年12月行全主动脉弓置换的143名TAAD患者,于术前至术后48 h 5个点采集静脉血,检测血清NGAL水平。AKI采用改善全球肾脏病预后组织(KDIGO)标准诊断。结果本研究人群平均年龄为(48±8.6)岁,其中男性占84.6%,73名(51.0%)患者术后发生AKI。AKI患者的血清NGAL水平显著高于未发生AKI的患者。多因素logistic回归显示,术后0时NGAL与AKI之间显著相关(P<0.001,OR=1.460,95%CI:1.246~1.710)。术后0时NGAL预测AKI的敏感性为83.6%,特异性为67.1%,曲线下面积=0.781(95%CI:0.705~0.857),最佳截止值57.35μg/L。结论NGAL可能是早期诊断TAAD全主动脉弓置换术后AKI的可靠生物标志物。
Objective To evaluate the diagnostic value of neutrophil gelatinase-associated lipocalin(NGAL)for acute kidney injury(AKI)after total aortic arch replacement in Stanford type A aortic dissection(TAAD)patients.Methods This was a prospec⁃tive study which collected 143 TAAD patients who underwent total aortic arch replacement in Xijing Hospital from October 2018 to De⁃cember 2019.Venous blood from preoperative to 48 hours after surgery was collected at 5 time points to detect serum NGAL levels.KDIGO criteria was used for AKI diagnosis.Results The average age of the study population was 48±8.6 years old,84.6%were male,and 73(51.0%)patients suffered postoperative AKI.The serum NGAL level of AKI patients was significantly higher than that of patients without AKI.Multivariate logistic regression showed that there was a significant correlation between NGAL(at postoperative 0 hour)and AKI(P<0.001,OR=1.460,95%CI=1.246-1.710).The sensitivity of NGAL(at postoperative 0 hour)in predicting AKI was 83.6%,the specificity was 67.1%,the AUC=0.781(95%CI=0.705-0.857)and the best cut-off value was 57.35μg/L.Conclusion NGAL may be a reliable biomarker for early diagnosis of AKI in TAAD patients after aortic total arch replacement.
作者
杨晨
侯鹏
周晔农
王东旭
丁伟
张超
王馨怡
王娇姣
段维勋
刘金成
白军锋
马鹏飞
金振晓
俞世强
Yang Chen;Hou Peng;Zhou Yenong;Wang Dongxu;Ding Wei;Zhang Chao;Wang Xinyi;Wang Jiaojiao;Duan Weixun;Liu Jincheng;Bai Junfeng;Ma Pengfei;Jin Zhenxiao;Yu Shiqiang(Department of Cardiovascular Surgery,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China)
出处
《中国体外循环杂志》
2022年第4期210-215,256,共7页
Chinese Journal of Extracorporeal Circulation
基金
陕西省重点研发项目(2019ZDLSF01-01-02)
陕西省社会发展计划(2020SF-250)
国家自然科学基金重点项目(51837011)
国家自然科学基金面上项目(82070503,81870218)。
