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目的:明确血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的变化能否预测婴幼儿先心病术后急性肺损伤(ALI)的发生。方法:纳入2013年10月至2014年5月年龄≤36月的先心病合并肺动脉高压的婴幼儿患者的相关资料,检测体外循环(CPB)术后2 h、12 h、24 h、48 h和72 h的血浆NGAL水平,分析NGAL与术后发生ALI之间的关系。结果:本研究共纳入患者61例,术后发生ALI患者9例(14.8%)。所有患者CPB术后5个时间点的变化趋势为:CPB术后2 h NGAL浓度开始升高,均值为27.28μg/L,至12 h达到最高峰,均值为30.61μg/L,24 h开始下降;其中12 h、24 h和72 h与前一时间点比较均具有显著性差异(P<0.05)。进一步分组显示,NGAL浓度变化趋势主要在ALI组:ALI组患者12 h、24 h、48 h和72 h的NGAL浓度与前一个时间点比较,变化均具有显著差异(P<0.05),NGAL峰值浓度出现在12 h,其均值为40.82μg/L;而无ALI组患者NGAL浓度只在24 h和12 h之间比较有显著差异(P<0.05);ALI组患者5个时间点的NGAL浓度均比无ALI组患者高,具有显著性差异(P<0.05)。结论:血浆NGAL在早期预测婴幼儿体外循环术后发生ALI可能具有重要作用。
Objective: To determine whether changes in plasma neutrophil gelatinase-associated lipocalin (NGAL) can predict acute lung injury (ALI) in infants with CHD. Methods: The data of infants with congenital heart disease complicated pulmonary hypertension from October 2013 to May 2014 were included in this study. The data of 2 h, 12 h, 24 h, 48 h after cardiopulmonary bypass (CPB) 72 h of plasma NGAL levels, analyze the relationship between NGAL and postoperative ALI. Results: A total of 61 patients were enrolled in this study. There were 9 patients (14.8%) with ALI after operation. The change trend of all the patients at 5 time points after CPB was as follows: NGAL concentration began to increase at 2 h after CPB, with an average of 27.28 μg / L and peaked at 12 h (mean 30.61 μg / L, 24 h) ; Among 12 h, 24 h and 72 h, there was significant difference compared with the previous time point (P <0.05). Further grouping showed that the trends of NGAL concentration were mainly in the ALI group. There was a significant difference (P <0.05) in NGAL concentration at 12 h, 24 h, 48 h and 72 h in the ALI group compared with the previous time point (P <0.05) The average concentration of NGAL in the group without ALI was only between 24 h and 12 h (P <0.05). The concentration of NGAL in the ALI group was 40.82 μg / L at 5 time points Were higher than those without ALI group, with significant difference (P <0.05). Conclusion: Plasma NGAL may play an important role in the early prediction of ALI after cardiopulmonary bypass.