尿肾损伤分子-1和尿N-乙酰-β-D-氨基葡萄糖苷酶在成人心脏手术后早期急性肾损伤中的诊断价值  

Value of kidney injury molecule-1 and N-acecyl-β-D-glucosaminidase to the diagnosis of early acute kidney injury after adult heart surgery

作　　者：刘红[1] 杨淑芬[1] 岳华[1] 陆晨[1] 刘颖[1] 赵红娟[1] 陶建双[2] 秦君玫[3] 

机构地区：[1]新疆维吾尔自治区人民医院肾脏病研究室,乌鲁木齐市830001 [2]新疆维吾尔自治区人民医院心脏外科,乌鲁木齐市830001 [3]新疆维吾尔自治区人民医院外科ICU,乌鲁木齐市830001

出　　处：《中华实用诊断与治疗杂志》2013年第2期144-146,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区人民医院课题(20100118)

摘　　要：目的探讨尿肾损伤分子-1(kidney injury molecule-1,Kim-1)及尿N-乙酰-β-D-氨基葡萄糖苷酶(N-acecyl-β-D-glucosaminidase,NAG)在成人心脏手术后急性肾损伤(acute kidney injury,AKI)中的敏感性及诊断价值。方法行心脏手术患者105例,根据AKI诊断标准分为AKI组65例与非AKI组40例,检测2组手术前、手术后24,48,72h尿Kim-1,NAG及血肌酐水平,并以ROC曲线及AUC评价各项指标诊断AKI的敏感性。结果 2组术前血肌酐、尿Kim-1及尿NAG水平比较差异均无统计学意义(P>0.05);术后不同时间点AKI组血肌酐、尿Kim-1及尿NAG水平较非AKI组明显升高(P<0.001);联合检测尿Kim-1及尿NAG最佳诊断时间点为48h,AUC为0.912(95%CI:0.786～0.939)。结论尿Kim-1及尿NAG联合检测可作为成人心脏手术后AKI早期诊断的指标,对预防AKI发生、发展有重要价值。Objective To explore the sensitivity of kidney injury molecule-1 （Kim 1） and N-acecyl-β-D-glucosaminidase （NAG） in early acute kidney injury （AKI） after adult heart surgery and their clinical diagnostic value. Methods A total of 105 cases were divided into AKI group （n=65） and non-AKI group （n=40）. The levels of Kim-1, NAG and serum creatinine （SCr） were detected before operation, and 24, 48 and 72 hours after operation. The sensitivity of AKI markers was assessed by using ROC and AUC. Results There were no significant differences in the levels of SCr, Kim 1 and NAG between two groups before operation （P〉0.05）. The biological markers of AKI were higher at different time points after operation in AKI group than those in non-AIKI group （P〈0. 01）. The best time of combined detection of Kim-1 and NAG was by 48 hours after operation, and AUC was 0. 912 （95GCI：0. 786 to 0. 939）. Conclusion The combined detection of Kim-1 and NAG can be used for early diagnosis of AKI after adult heart surgery, and has a great value to the prevention of occurrence and development of AKI.

关 键 词：急性肾损伤 肾损伤分子-1 尿N-乙酰-Β-D-氨基葡萄糖苷酶 心脏手术 诊断价值 

分 类 号：R692[医药卫生—泌尿科学]