Objective To explore the value of neutiophil gelatinase-associated lipocalin ( NGAL) taken from blood and urine samples in early diagnosis of acute kidney injury ( AKI) after heart valves replacement surgeries. Meth-ods A total of 56 patients received heart valves replacement surgeries were selected prospectively in this study. NGAL from blood and urine samples and serum creatinine ( Scr) were tested among them at different moments. AKI and non-AKI groups were divided based on Scr levels and the value of NGAL taken from blood and urine sam-ples was estimated in early diagnosis of AKI with receiver operating characteristic curve ( ROC) . Results 16 AKIs were observed among all of them. The peak value of Scr in AKI group was shown between 12 and 24 hours after surgeries, while blood-NGAL was seen high significantly (P<0.05) since 2 hours after surgeries, peak value at 4 hours, for urine-NGAL, peak value was seen at 2 hours. The area of ROC of blood-NGAL 4 hours and urine-NGAL 2 hours after surgeries for AKI diagnosis were 0.891 and 0.934, respectively. The better sensitivity and specificity were shown in both threshold set as 50 μg/L and 110 μg/L. Conclusion Blood-NGAL and urine-NGAL can be used as early diagnostic markers of AKI after heart valves replacement surgeries, whose change is significantly earli-er than that of Scr.%目的探讨血、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在心脏瓣膜置换术后急性肾损伤(AKI)中的早期诊断价值。方法前瞻性收集56例接受心脏瓣膜置换手术患者不同时相的血、尿标本,分别测定血、尿NGAL和血肌酐( Scr)。依Scr水平分为AKI组和非AKI组,利用受试者工作特征( ROC )曲线评价血、尿NGAL对AKI的早期诊断价值。结果56例患者中有16例发生AKI,AKI组中Scr升高峰值出现在术后12~24 h内,术后2 h血NGAL开始显著升高(P<0.05),4 h时达峰值,术后2 h尿NGAL开始升高,并达到峰值；术后4 h 血 NGAL 及术后2 h 尿 NGAL 诊断AKI的 ROC 曲线下面积分别为0.891,0.934,分别以50μg/L及110μg/L作为AKI的诊断界限时均表现出较高的敏感性及特异性。结论心脏瓣膜置换术后,血、尿NGAL可作为AKI发生的早期诊断标志物,其水平变化的时间早于Scr的变化。
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