尿肝型脂肪酸结合蛋白对肺移植术后急性肾损伤的早期诊断及进展判断  

Value of urine L-FABP in early diagnosis and progress predicting of acute kidney injury after lung transplantation

作　　者：陈彩妹[1] 孙铸兴[1] 薛婧[1] 刘晓斌[1] 王凉[1] 

机构地区：[1]南京医科大学附属无锡市人民医院肾脏科,江苏省无锡市214000

出　　处：《实用医学杂志》2017年第1期26-29,共4页The Journal of Practical Medicine

基　　金：无锡市科技发展指导性计划项目(CSZ00N1207)

摘　　要：目的:探讨尿肝型脂肪酸结合蛋白(L-FABP)在肺移植术后急性肾损伤(AKI)早期诊断及预测进展中的价值。方法:收集行肺移植手术患者围手术期尿液和血液标本,分别检测尿L-FABP和血肌酐(Scr)。根据KDIGO标准中Scr标准将患者分为AKI组和非AKI组。观察两组各时间点尿L-FABP和Scr水平动态变化。结果:119例患者中57例术后发生AKI。两组术后即刻至48 h尿L-FABP均显著升高,其中6~48 h两组间差异有统计学意义。在诊断价值上,尿L-FABP术后6 h的ROC曲线下面积(AUC)为0.818,取2 254.52 ng/mg Cr为AKI诊断截点时,其诊断AKI的敏感性和特异性为0.782和0.814;在预测AKI进展上,尿L-FABP术后6 h的ROC下AUC为0.852,取4313.17 ng/mg Cr为AKI诊断截点时,预测AKI进展的敏感性和特异性为0.867和0.700。结论:尿L-FABP在肺移植术后早期诊断及预测AKI进展上表现出较高的敏感性和特异性,也许能作为AKI早期诊断并判断其进展趋势的生物学标志物。Objective To investigate the value of urine liver-type fatty acid-binding proteins （L-FABP） for early diagnosis and progress predicting of acute kidney injury （AKI） after lung transplantation. Methods Urine L-FABP and Scr blood samples in perioperative periods of 119 lung transplant recipients （hospitalized between 2013-2014） were involved in the research. Patients were divided into AKI group and non-AKI group according to KDIGO. Changes in urine L-FABP and Scr of two groups at various time points were recorded. Results Of 119 patients, 57 developed AKI after surgery. Urine L-FABP from 0 h to 48 h in the two groups increased significantly, and the difference at 6 h to 48 h between the two groups is significant. In terms of diagnostic value, ROC area of urine L-FABP at 6h is 0.818. When 2254.52 ng/mg Cr was taken as diagnostic dividing line, sensitivity and specificity was 0.782 and 0.814. In predicting AKI progression, AUC below AUC of urine L-FABP 0.852. When 4313.17 ng/ mgCr was taken as diagnostic dividing line, sensitivity and specificity was 0.867 and 0.700. Conclusion Urinary L-FABP appears to be a sensitive and specific marker of AKI in lung transplant recipients, could be a biological marker in the early diagnosis and progression tendency of AKI.

关 键 词：急性肾损伤 肺移植 肝型脂肪酸结合蛋白 诊断 进展 

分 类 号：R655.3[医药卫生—外科学] R692.5[医药卫生—临床医学]