脓毒症患者血清NGAL、KIM-1、Cys-C对急性肾损伤的诊断能效  

Diagnostic efficacy of serum NGAL, KIM-1 and Cys-C for acute kidney injury in sepsis patients

作　　者：刘瑞清[1] 孟志云[1] 褚洪光[2] 厉兆春 LIU Ruiqing;MENG Zhiyun;CHU Hongguang;LI Zhaochun(Department of Nephrology,Weifang Traditional Chinese Medicine Hospital,Shandong Province,Weifang 261000,China;Department of Ultrasonography,Weifang Traditional Chinese Medicine Hospital,Shandong Province,Weifang 261000,China)

机构地区：[1]山东省潍坊市中医院肾内科,山东潍坊261000 [2]山东省潍坊市中医院超声科,山东潍坊261000

出　　处：《中国医药导报》2019年第29期128-131,共4页China Medical Herald

基　　金：山东省潍坊市卫生计生委科研项目（2017wsjs053）;山东省医药卫生科技发展计划项目（2017WS184）

摘　　要：目的探讨脓毒症患者血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、肾损伤分子-1(KIM-1)、胱抑素C(Cys-C)对急性肾损伤(AKI)的诊断价值。方法收集山东省潍坊市中医院ICU收治的89例脓毒症患者,连续观察48 h,根据患者是否出现AKI分为AKI组(42例)和非AKI组(47例)。采用双抗体夹心酶标免疫分析法测定各组患者入院0、6、12、24、48 h血清NGAL、KIM-1水平,免疫比浊法检测血清Cys-C水平。结果两组患者入院后血清NGAL、KIM-1、Cys-C水平在不同时点两两比较,差异有统计学意义(P<0.05)。AKI组血清NGAL、KIM-1、Cys-C水平均高于非AKI组同期水平,差异有统计学意义(P<0.05)。AKI组患者,血清NGAL与KIM-1、Cys-C呈正相关(P<0.05),血清KIM-1与Cys-C呈正相关(P<0.05)。入院6 h时血清NGAL、KIM-1、Cys-C对脓毒症患者发生AKI具有较高预测价值,联合预测时的ROC曲线下面积为0.891(95%CI:0.869~0.972),灵敏度0.93,特异性0.87,准确性0.91。结论血清NGAL、KIM-1、Cys-C联合检测可早期预测脓毒症患者AKI,具有一定的临床参考意义。Objective To explore the diagnostic value of serum neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1)and cystatin C(Cys-C)for acute kidney injury(AKI)in sepsis patients.Methods A total of eithty-nine patients with sepsis admitted to ICU of Weifang Traditional Chinese Medicine Hospital of Shondong Province were observed continuously for 48 hours,who were divided into AKI group(42 cases)and non-AKI group(47 cases)according to the presence of AKI.Serum NGAL,KIM-1 levels were measured by double antibody sandwich enzyme-labeled immunoassay at 0,6,12,24,48 hous after admission,while serum Cys-C level was detected by immunoturbidimetry.Results Serum NGAL,KIM-1,and Cys-C levels were compared between the two groups at different time points,and the differences were statistically significant(P<0.05).The serum levels of NGAL,KIM-1 and Cys-C in AKI group were higher than those in non-AKI group at the same time,and the differences were statistically significant(P<0.05).Serum NGAL was positively associated with KIM-1 and Cys-C in AKI group,while serum KIM-1 was positively associated with Cys-C(P<0.05).Serum NGAL,KIM-1 and Cys-C have high predictive value for AKI in sepsis patients at 6 hours after admission,and the area under ROC curve was 0.891(95%CI:0.869-0.972),the sensitivity and specificity were 0.93 and 0.87,respectively,while the accuracy was 0.91.Conclusion Combined detection of serum NGAL,KIM-1 and Cys-C can predict early AKI in sepsis patients,which has certain clinical reference significance.

关 键 词：脓毒症 急性肾损伤 中性粒细胞明胶酶相关载脂蛋白 肾损伤分子-1 胱抑素C 预测价值 

分 类 号：R631[医药卫生—外科学]