尿KIM-1、L-FABP、NGAL检测对早期AKI患儿的诊断价值探讨  

Diagnostic value of urine KIM-1,L-FABP and NGAL in detecting children with early AKI

作　　者：祁洁[1] 王钊华[2] 董自杰[3] 赵鸿斌 QI Jie;WANG Zhao-hua;DONG Zi-jie(Department of Clinical Laboratory,Shijiazhuang First Hospital,Shijiazhuang Hebei 050000,China;Department of Clinical Laboratory,Shijiazhuang Fourth Hospital,Shijiazhuang Hebei 050011,China;Department of Clinical Laboratory,Shijiazhuang Third Hospita ,Shijiazhuang Hebei 050011,China)

机构地区：[1]石家庄市第一医院检验科,河北石家庄050000 [2]石家庄市第四医院检验科,河北石家庄050011 [3]石家庄市第三医院检验科,河北石家庄050011

出　　处：《临床和实验医学杂志》2019年第22期2438-2441,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫计委指导性科技成果推广课题(编号:20170092)

摘　　要：目的探讨尿液中肾损伤分子-1(KIM-1)、肝型脂肪酸结合蛋白(L-FABP)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)检测对于早期儿童急性肾损伤(AKI)的诊断价值。方法前瞻性研究,选取2016年1~12月在石家庄市第一医院治疗的200例患儿作为研究对象,根据最终确诊结果分为AKI组74例、非AKI组126例,检测并对比两组患儿的尿KIM-1、L-FABP、NGAL及血肌酐(Scr)水平,采用受试者工作曲线(ROC)求取AKI的最佳临界值及诊断效能。结果诊断前48 h、24 h以及诊断当天,AKI组患儿的尿KIM-1、L-FABP、NGAL检测值均高于非AKI组,差异具有统计学意义(P<0.05);诊断当天,AKI组的Scr水平高于非AKI组患儿,差异具有统计学意义(P<0.05);确诊前48 h,KIM-1+L-FABP+NGAL鉴别诊断AKI患儿的灵敏度为89.37%、特异度为95.50%,AUC值为0.942;确诊前24 h,KIM-1+L-FABP+NGAL鉴别诊断AKI患儿的灵敏度为96.77%、特异度为98.14%,AUC值为0.971。结论尿KIM-1、L-FABP、NGAL三者联合应用更有利于早期诊断AKI患儿。Objective To investigate the diagnostic value of urine kidney injury molecule-1(KIM-1),liver type fatty acid binding protein(L-FABP)and neutrophil gelatinase associated lipocalin(NGAL)in early detection of acute kidney injury(AKI).Methods This prospective study selected 200 children treated in the first hospital of Shijiazhuang City from January to December 2016 as the research subjects.According to the final diagnosis,they were divided into AKI group(74 cases)and non AKI group(126 cases).The urine KIM-1,L-FABP,NGAL and serum creatinine(Scr)level were detected and compared between two groups.The optimal cut-off value and diagnostic efficiency were evaluated by receiver operating characteristic curve(ROC).Results At 48 h before diagnosis,24 h before diagnosis and on the day of diagnosis,the values of urine KIM-1,L-FABP and NGAL in the AKI group were significantly higher than those in the non-AKI group(P<0.05).On the day of diagnosis,the Scr level in the AKI group was significantly higher than that in the non-AKI group(P<0.05).At 48 h before diagnosis,the sensitivity,specificity and AUC value of KIM-1+L-FABP+NGAL in diagnosis of AKI was 89.37%,95.50%and 0.942 respectively.At 24 h before diagnosis,the sensitivity,specificity and AUC value of KIM-1+L-FABP+NGAL in diagnosis of AKI was 96.77%,98.14%and 0.971 respectively.Conclusion The combination of urine KIM-1,L-FABP and NGAL is more conducive to the early diagnosis of AKI in children.

关 键 词：急性肾损伤 肾损伤分子-1 肝型脂肪酸结合蛋白 中性粒细胞明胶酶相关脂质运载蛋白 

分 类 号：R446.12[医药卫生—诊断学] R726.9[医药卫生—临床医学]