血清胱抑素C和尿NGAL联合检测在急性肾损伤病情评估及预后中的价值  

Combining Detection of Serum Cystatin C and Urinary NGAL to Predict Severity and Clinical Outcomes of Acute Kidney Injury

作　　者：吴家玉[1] 熊冠泽[1] 丁福全[1] 雷军[1] 卢松[1] 徐珊玲[1] 熊中华[1] 

机构地区：[1]四川省肿瘤医院重症监护室,四川成都610041

出　　处：《中山大学学报（医学科学版）》2014年第1期152-155,F0003,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：四川省卫生厅项目(120051)

摘　　要：【目的】评价血清胱抑素C(Cys C)及尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合检测在急性肾功能损伤(AKI)病情评估及预后中的临床价值及意义。【方法】选取2010年1月至2011年12月我院住院收治的90例AKI患者(AKI组)的血液标本,均符合AKI诊断标准。根据AKI分期标准分为AKI 1期组(30例)、AKI 2期组(30例)和AKI 3期组(30例),记录其血清Cys C、尿NGAL的变化,并对其进行APACHEⅡ评分,分析Cys C及NGAL与APACHEⅡ的相关性,评价两者联合检测在AKI患者中的预后价值。【结果】与其它3组相比,AKI 3期患者血清Cys C及尿NGAL水平显著升高,差异有统计学意义(P<0.05);AKI患者血清Cys C、尿NGAL与APACHEⅡ成明显线性相关(r值分别为0.877、0.717,P<0.05);AKI患者死亡率为28.89%(26/90),血清Cys C及尿NGAL水平随APACHEⅡ评分增多而升高,存活组与死亡组之间比较差异有统计学意义(P<0.05);高Cys C+NGAL组APACHEⅡ评分及病死率明显高于高Cys C及高NG AL组,差异有统计学意义(P<0.05)。【结论】急性AKI患者血清Cys C和尿NGAL均升高,血清Cys C及尿NGAL是反映AKI较敏感的生物学标志物,可以作为评价AKI患者病情和预后的指标。[Objective] To evaluate the serum cystatin C （Cys C） and the urinary neutrophil gelatinase-associated lipocalin （NGAL） level of the patients with the acute kidney injury （AKI） and to assess its clinical significance. [Methods] A total of 90 cases of AKI from January 2010 to December 2011 were divided into AKI 1 group （30 cases） , AKI 2 group （30 cases）, and AKI 3 group （30 cases）, and 30 healthy having physical examination in the same period were involved as control group. The levels of Cystatin C and NGAL were detected. The condition assessment adopted APACHE II was recorded during hospitalization. The correlation of Cystatin C, NGAL, and APAC-HE II was analyzed. [Results] The levels of Cystatin C and NGAL of AKI 3 group and control group showed statistically significant differences respectively （P 〈 0.05 ）. Cystatin C and NGAL were positively correlated with APACHE II （r = 0.877 and 0.717, P 〈 0.05）. The APACHE II of AKI1 group, AKI2 group, and AKI3 group showed statistically significant difference （P〈0.05） . The mortality of AKI was 28.89%, the level of Cystatin C and NGAL were rising with the APACHE II scores increased, and there was statistically significant differences between the survival group and mortality group （P 〈 0.05 ）. The levels of Cystatin C and NGAL in AKI with high Cystatin C and NGAL both showed statistically significant differences with high Cystatin C group or high NGAL group （P 〈 0.05 ）. [ Conclusion] The serum cystatin C and urinary NGAL of AKI patients were both increased, it has important clinical value to predict the severity and clinical outcomes of AKI.

关 键 词：急性肾损伤 血清胱抑素C 尿NGAL 临床预后 

分 类 号：R446[医药卫生—诊断学]