尿KIM-1和胱抑素C对重症肺炎患者发生急性肾损伤早期诊断的预测价值  

The predictive value of the urinary KIM - 1 and cystatin C in early diagnosis of acute kidney injury occurred in patients with severe pneumonia

作　　者：高飞[1] 严洁[1] 

机构地区：[1]南京医科大学附属无锡人民医院重症医学科,江苏无锡214023

出　　处：《中国急救医学》2015年第9期840-843,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨尿肾损伤分子-1（KIM-1）及胱抑素c对重症肺炎合并急性肾损伤（AKI）早期诊断的预测价值。方法前瞻性选取2013—10～2014—10在我院ICU及EICU收治的70例重症肺炎患者为研究对象，分别在0、3、6、12、24、48h采集尿液及血液标本，采用酶联免疫吸附法（ELISA）检测KIM-1及乳胶颗粒增强透射免疫比浊法（PETIA）检测胱抑素c。根据重症肺炎患者是否在住院期间发生AKl分为重症肺炎AKI组、重症肺炎非AKI组，并进行对比分析。结果在ICU及EICU住院期间32例发生AKI，AKI发生率为45．71％。AKI组尿KIM-1在6、12、24、48h和胱抑素c在12、24、48h高于非AKI组（P〈0．05）；6h尿KIM-1和12h胱抑素c与确诊AKI时24h血肌酐（sCr）呈正相关（r=0．883，P=0．000；r=0．703，P=0．000）。6h尿KIM-1和12h胱抑素C的ROC曲线下面积（AUC）分别为0．875（95％C10．795—0．955）和0．836（95％C10．743—0．929）。结论尿KIM-1和胱抑素c较sCr更早出现升高，故检测尿KIM-1和胱抑素C对莺症肺炎患者是否发生AKI的预测具有一定价值。Objective To investigate the predictive value of the urinary kidney injury molecule - 1 （ KIM - 1 ） and cystatin C in early diagnosis of acute kidney injury occurred in patients with severe pneumonia. Methods We prospectively collected 70 cases of severe pneumonia patients who admitted to ICU and EICU in our hospital from Oct. 2013 to Oct. 2014. 0, 3, 6, 12, 24, 48 h urine and blood samples were collected, using enzyme -linked immunosorbent assay （ELISA） to detect KIM - 1 and the latex particle enhanced immunoturbidimetric method transmittance （PETIA） to detect cystatin C. Results During this period the ICU and EICU hospitalization AKI were 32 cases, AKI incidence was 45.71%. AKI urinary KIM- 1 at 6, 12, 24, 48 h and cystatin C in 12, 24, 48 h was higher than non - AKI group （P 〈 0.05 ） ; 6 h and 12 h urinary KIM - 1 cystatin C and diagnosed AKI 24 h when serum creatinine （sCr） were positively correlated （ r = 0. 883, P = 0. 000 ; r = 0. 703, P = 0. 000）. Area under the ROC curve for 6 h urinary KIM - 1 and 12 h cystatin C （AUC） were 0. 875 （95% CI 0. 795 ~ 0. 955 ） and 0. 836 （95% CI 0. 743 - 0. 929 ）, respectively. Conclusion The urinary KIM - 1 and cystatin C appear earlier than the sCr, so the detection of urinary KIM - 1 and cystatin C has a certain value for patients with severe pneumonia to predict the occurrence of acute kidney injury.

关 键 词：肾损伤分子-1(KIM-1) 胱抑素C 重症肺炎 急性肾损伤(AKI) 

分 类 号：R563.1[医药卫生—呼吸系统]