血清Cys C,NGAL及尿IL-18对ICU儿童急性肾损伤的早期诊断价值  

Early Diagnostic Value of the Detection of Serum Cys C,NGAL and Urinary IL-18 for Acute Kidney Injury in Pediatric Intensive Care Units

作　　者：白香妮 张英 

机构地区：[1]西电集团医院检验科,西安710077 [2]西电集团医院西开分院检验科,西安710077

出　　处：《现代检验医学杂志》2017年第5期104-107,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清胱抑素C(Cys C)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及尿白细胞介素-18(IL-18)对ICU重症儿童急性肾损伤(AKI)的早期诊断价值。方法选取2015年6月～2017年2月入住西电集团医院ICU的重症患儿114例作为研究对象,根据患儿是否继发AKI,将其分为AKI组(64例)和非AKI组(50例),同时从同期健康体检者中选取50例作为对照组。检测各组受试者血肌酐(Scr)、尿素(BUN)、血清Cys C,NGAL及IL-18水平;采用Pearson分析法分析AKI组患儿各指标间相互关系;通过AKI患儿工作特征曲线(ROC)分析血清Cys C,NGAL及尿IL-18在AKI诊断中的价值。结果 AKI组患儿Scr,BUN,血清Cys C,NGAL及尿IL-18水平均明显高于非AKI组和对照组,差异均具有统计学意义(t=3.137～28.642,t_1=7.653～33.672,均P<0.05);血清Cys-C,NGAL水平与Scr水平呈正相关(Beta=0.273,0.514,均P<0.05),尿IL-18水平与血清清蛋白(Alb)呈负相关(Beta=-0.342,P<0.05);血清Cys C,NGAL及尿IL-18 ROC曲线下面积(ACU)分别为0.872(95%CI:0.831～0.936),0.823(95%CI:0.641～0.925)和0.714(95%CI:0.598～0.833)。结论血清Cys C及NGAL水平升高早于Scr,可作为ICU重症儿童AKI早期临床诊断的可靠指标。Objective To explore the diagnosis value of serum eystatin C （Cys C）, neutrophil gelatinase-associated lipocalin （NGAL） and urinary interleukin-18 （IL-18） levels in critically cases from pediatric Intensive Care Units （ICU）. Methods 114 cases from June 2015 to January 2017 in Xidian Group Hospital were enrolled in the study. According to whether cases secondary to AKI,they were divided into AKI group （64 cases） and non-AKI group （50 cases）. At same time 50 healthy ca ses were selected as the control group. The Serum creatinine （Scr）, urinary nitrogen （BUN）, Cys C, NGAL and urinary IL- 18 levels were measured in each subject. The relationship between the indexes of AKI group was analyzed by Pearson analysis. The value of serum Cys-C,NGAL and urinary IL-18 in the diagnosis of AKI was analyzed by receiver operating charac teristic （ROC） curve. Results Serum Cys-C,NGAL and urinary IL-18 levels of the AKI group were higher than that of the non-AKI group and the control group, the difference had statistical significance （t= 3. 137 - 28. 642, t1= 7. 653- 33. 672, all P〈0.05）. The levels of serum Cys-C and NGAL were positively correlated with Scr levels （Beta： 0. 273,0. 514, all P〈 0.05）. The urinary IL-18 levels were negatively correlated with serum albumin （Alb）（Beta：-0. 342 ,P〈0.05）. The area under the ROC carve （AUC） of serum Cys-C,NGAL and urinary IL-18 was 0. 872 （95% CI：0. 831-0. 936） ,0. 823 （95% CL0. 641±0. 925） and 0. 714 （95%CI：0. 598±0. 833）. Conclusion The levels of serum Cys-C and NGAL were elevated earlier than Scr,and it can be used as reliable indicators of early diagnosis of early cases AKI in ICU.

关 键 词：急性肾损伤 血清胱抑素C 中性粒细胞明胶酶相关脂质运载蛋白 白介素-18 

分 类 号：R692[医药卫生—泌尿科学] R392.11[医药卫生—外科学]