尿中性粒细胞明胶酶相关脂质运载蛋白对急性肾损伤的诊断价值  

Diagnositic value of urinary neutrophil gelatinase-associated lipocalin distinguished on acute kidney injury

作　　者：刘进[1] 杨满[1] 梅丽凡[2] 

机构地区：[1]泸州医学院附属医院肾内科,四川泸州646000 [2]南方医科大学附属中山市博爱医院肾内科,广东中山528403

出　　处：《重庆医学》2015年第13期1735-1737,1740,共4页Chongqing medicine

基　　金：四川省卫生厅科研课题(130372)

摘　　要：目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)鉴别肾前性和肾性急性肾损伤(AKI)的价值。方法酶联免疫吸附试验(ELISA)法检测197例确诊AKI患者尿NGAL的浓度。研究人员在不知实验室检测结果的情况下进行分类,17例因肾后梗阻或临床资料不足而被排除。其余的180例中有94例诊断为肾性AKI,51例为肾前性AKI、35例不可分类,并进行受试者工作特征(ROC)曲线分析。结果肾性AKI患者尿NGAL水平明显高于肾前性AKI患者(平均273.3 vs.37.5μg·g-1·Cr,P<0.05),NGAL的ROC曲线下面积(0.90)明显高于所试验的其他标志物,其临界值为125μg·g-1·Cr时,检出AKI的特异性和敏感性分别为0.80和0.91。尿NGAL>125μg·g-1·Cr表示肾性AKI,NGAL<125μg·g-1·Cr表示肾前性AKI。结论确诊AKI患者尿NGAL水平能有效地区分肾前性和肾性AKI。Objective To investigate the value of urinary neutrophil gelatinase-associated lipocalin（NGAL） for distinguishing prerenal acute kidney injury（AKI） from renal AKI. Methods The urinary NGAL concentration was measured by ELISA in 197 hospitalized patients with AKI and classified by researchers who were blinded to the measurement results. 17 patients were excluded because of postrenal obstruction or insufficient clinical information. Of the remaining 180 cases, 94 cases were diagnosed as renal AKI, 51cases as prerenal AKI and 35 cases as unclassification. The receiver coperating characteristic（ROC） curve analysis was per- formed. Results The patients with renal AKI had a siginificantly elevated urinary NGAL level compared with the prerenal group （mean 273.3 vs. 37.5 μg·g^-1 o Cr creatinine,P〈0.05）. The areas under the ROC curve of NGAL（0.90） was significarty higher than that of other tested marker. At a cutoff value of 125 /μg·g^-1 . Cr creatinine,the sensitivity and specificity of urinary NGAL for detecting AKI were 0.80 and 0. 91 repectively. Urinary NGAL level ~ 125 ~g ~ g-1 . Cr creatinine indicated renal AKI. and which 〈125μg·g^-1 . Cr creatinine indicated prerenal AKI. Conclusion Urinary NGAL level can effectively distinguish prerenal AKI from renal AKI in diagnosing AKI.

关 键 词：肾前性 肾性 急性肾损伤 鉴别诊断 

分 类 号：R692[医药卫生—泌尿科学]