Abstract：Objective To investigate the early diagnostic value of neutrophil gelatinase-associated lipid-carrying proteins (NGAL) in cardiorenal syndrome (CRS).MethodsA total of 165 patients with heart failure (HF) who were admitted to Shangrao People′s Hospital from November 2017 to October 2018 were seleted as the research objects.According to the CRS diagnostic guidelines,38 patients with acute decompensated heart failure (ADHF) and new acute kidney injury (AKI) were selected as the CRS group,and the remaining 127 patients were assigned as the control group.The urine NGAL (uNGAL),N-terminal pro-brain natriuretic peptide (N-proBNP),cystatin (Cys-C),urea nitrogen (BUN),and creatinine (SCr) levels were compared between the two groups.The levels of uNGAL,SCr,Cys-C and BUN at 0(baseline),2,4,8,18,48 h of CRS group were detected respectively.The value of uNGAL in the diagnosis of CRS was analyzed by receiver operating characteristic (ROC) curve.Results The levels of SCr,BUN,uNGAL,Cys-C and NTproBNP in the CRS group were higher than those in the control group,and the differences were statistically significant(P<0.05).The SCr and BUN levels in the CRS group at 48 h were significantly higher than those at the baseline,and the differences were statistically significant (P<0.05).The levels of uNGAL in the CRS group at 2,4,8,18,and 48 h were significantly higher than those at the baseline,the differences were statistically significant (P<0.05),and peaked at 2 and 4 h.The Cys-C levels at 4,8,18,and 48 h in the CRS group were higher than those at the baseline,and the differences were statistically significant (P<0.05).The ROC curve analysis showed that the AUC of the diagnosis of AKI at 2,4,8,and 18 h were 0.879,0.862,0.848,and 0.813,95% CI was 0.768-0.981,0.735-0.977,0.723-0.971,and 0.741-0.954,respectively.When 169.1 ng/ml was used as the cut-off value for the diagnosis of AKI,the sensitivity and specificity were 95.61% and 87.52%,respectively.Conclusion The uNGAL is associated with AKI in patients with ADHF during hospitalization,and it is an early independent predictor of renal function deterioration during hospitalization of HF patients,which is of great significance in the early diagnosis and early intervention of CRS patients.
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