J Card Fail:尿中性粒细胞明胶酶相关脂联素对急性心力衰竭住院期间肾功能恶化的作用

2020-07-24 MedSci原创 MedSci原创

急性心力衰竭(AHF)期间肾功能恶化(WRF)经常发生,并与不良后果相关,尽管这种关联性受到质疑。现在,通过功能和损伤来评估WRF。我们评估了对AHF患者WRF的预测和预后, 尿中性粒细胞明胶酶相关脂

急性心力衰竭(AHF)期间肾功能恶化(WRF)经常发生,并与不良后果相关,尽管这种关联性受到质疑。现在,通过功能和损伤来评估WRF。我们评估了对AHF患者WRF的预测和预后, 尿中性粒细胞明胶酶相关脂联素(uNGAL)是否优于肌酐。

 

我们对需要静脉利尿剂的AHF患者进行了多中心、国际化、前瞻性的队列研究。主要结果是uNGAL是否预测WRF的发展,定义为在最初5天内肌酐持续增加0.5mg/dL或高于首值≥50%或开始肾脏替代治疗。主要次要结果是院内不良事件的复合。

 

结果,纳入了927名患者(平均年龄68.5岁,62%为男性)。72名患者(7.8%)发生主要结果。uNGAL与尿肌酐的首发、峰值和的比值(曲线下面积(AUC)≤0.613)不比第一肌酐(AUC 0.662)有诊断效用。144名患者共发生235例不良事件,uNGAL对不良临床事件的预测(AUC≤0.647)并不优于肌酐(AUC 0.695)。

 

总之,该结果表明,uNGAL在预测WRF或院内不良结果方面不优于肌酐,不能推荐用于AHF的WRF。

 

原始出处:

 

Patrick T MurrayNicholas Wettersten, et al., Utility of Urine Neutrophil Gelatinase-Associated Lipocalin for Worsening Renal Function during Hospitalization for Acute Heart Failure: Primary Findings of the Urine N-gal Acute Kidney Injury N-gal Evaluation of Symptomatic Heart Failure Study (AKINESIS). J Card Fail. 2019 Aug;25(8):654-665. doi: 10.1016/j.cardfail.2019.05.009.

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    2020-08-24 晓辰
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