uNGAL在危重病患者急性肾损伤中的诊断意义  

Diagnostic value of urinary NGAL in acute renal injury in critically ill patients

作　　者：张连东[1,2] 裴新军[1,2] 谭美春[1,2] s徐兴凯 施巍[1,2] 姜颢[1,2] 

机构地区：[1]南京中医药大学,江苏南京210023 [2]上海市宝山区中西医结合医院重症监护病房,上海201900

出　　处：《中国急救医学》2016年第8期692-695,共4页Chinese Journal of Critical Care Medicine

基　　金：上海市卫计委课题（2012aa422110）

摘　　要：目的评估尿液中性粒细胞明胶酶相关脂质运载蛋白（urinary neutrophil gelatinase—associated lipocalin，uNGAL）对危重病患者急性肾损伤（AKI）的早期诊断作用。方法选择上海市宝山区中西医结合医院ICU162例危重病患者，收集患者一般情况、急性生理与慢性健康状况评分Ⅱ（acute physiology and chronic health evaluation，APACHEⅡ）及序贯器官衰竭估计评分（sequential organ failure assessment，SOFA），以及检测0、24、48h血肌酐（SCr）和uNGAL。比较分析AKI与非AKI患者指标水平，应用ROC曲线评价uNGAL对危重病患者AKI诊断的敏感度和特异度。结果AKI患者与非AKI患者uNGAL、SCr水平比较差异有统计学意义（P〈0．05）。参考2012改善全球肾脏病预后组织指南，将AKI患者分为三期，随着分期的升高，患者uNGAL与SOFA评分均呈上升趋势。uNGAL的ROC曲线下面积为0．838，敏感度与特异度均优于SCr。结论uNGAL有助于早期诊断AKI，可能对AKI严重程度提供帮助。Objective To estimate the predictive value of urinary neutrophil gelatinase-associated lipocalin （uNGAL） on detection of acute kidney injury （AKI） in critically ill patients. Methods A total of 162 participants from ICU of Shanghai Baoshan 14ospital were enrolled in the study. The relevant clinical data were collected. In 0, 24 , 48 11 uNGAL, serum creatinine were detected. Acute physiology and chronic health evaluation H （APACHE 1 ） and sequential organ failure assessment （SOFA） were assessed and compared between AKI and non-AKI patients. Diagnostic significance of uNGAL was evaluated by a receiver operating characteristic （ ROC ） curve. Results There was significant difference of uNGAL and serum creatinine levels between AKI patients and non-AKI patients （P 〈 0.05）. In patients among grade AKI 1 - 3, the uNGAL value and SOFA score were increased with the increase of grade. The area under the ROC curve of uNGAL was 0.838, the sensitivity and specificity were better than that of serum creatinine. Conclusion uNGAL is helptul for early diagnosis of AKI, and may be predictive for the severity of AKI.

关 键 词：尿液中性粒细胞明胶酶相关脂质运载蛋白(uNGAL) 急性肾损伤(AKI) 危重病 受试者工作特征曲线(ROC) 

分 类 号：R181.34[医药卫生—流行病学]