mALB、Hcy及NGAL联合检测在急性脑梗死合并肾损伤中的预测价值  

Predictive Value of Combined Detection of mALB,Hcy and NGAL in Acute Cerebral Infarction with Renal Injury

作　　者：宫萍[1] 张伟[2] 孙易南 胡佳宇 GONG Ping;ZHANG Wei;SUN Yi-nan(Department of Geriatrics,Peking University Third Hospital,Beijing 100191)

机构地区：[1]北京大学第三医院老年病内科,北京100191 [2]首都医科大学友谊医院神经内科,北京100050

出　　处：《医学临床研究》2020年第6期847-850,共4页Journal of Clinical Research

摘　　要：【目的】探讨尿微量白蛋白(mALB)、同型半胱氨酸(Hcy)及中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合检测在急性脑梗死合并肾损伤中的预测价值.【方法】选择2016年2月至2018年12月在本院诊治的急性脑梗死患者80例,按是否发生肾损伤分为急性脑梗死合并肾损伤组(A组,n=47)和单纯急性脑梗死组(B组,n=33),另外选取同期在本院的健康体检者35例设为对照组(C组).比较三组受试者的尿液mALB、血清Hcy及NGAL水平,分析上述指标对肾损伤的阳性检出率,采用直线回归分析尿液mALB、血清Hcy及NGAL水平与急性脑梗死合并肾损伤相关性,采用ROC曲线分析mALB、Hcy及NGAL水平单独及联合对急性脑梗死合并肾损伤的预测价值.【结果】A组尿液mALB、血清Hcy及NGAL水平和阳性检出率均显著高于B组和C组,其差异均有统计学意义(P<0.05).直线回归分析显示:mALB、Hcy及NGAL水平与急性脑梗死合并肾损伤均明显相关(P<0.05).ROC分析提示,三者联合检测的ACU下面积均大于单独检测,且联合检测可提高预测灵敏度和特异性(P<0.05).【结论】急性脑梗死合并肾损伤患者尿液mALB、血清Hcy及NGAL水平显著增高,且与合并肾损伤呈正相关,三项指标联合检测在合并肾损伤的诊断中具有较高价值.【Objective】To investigate the predictive value of combined detection of urinary microalbumin(mALB),homocysteine(Hcy)and neutrophil gelatinase associated lipocalin(NGAL)in acute cerebral infarction with renal injury.【Methods】Eighty patients with acute cerebral infarction treated in our hospital from February 2016 to December 2018 were divided into acute cerebral infarction combined with renal injury group(group A,n=47)and simple acute cerebral infarction group(group B,n=33)according to whether renal injury occurred.In addition,35 healthy physical examinees in our hospital at the same time were selected as control group(Group C).The levels of urine MLB,serum Hcy and NGAL of the three groups were compared,and the positive detection rate of the above indexes on renal injury was analyzed.The correlation between the levels of urine MLB,serum Hcy and NGAL and acute cerebral infarction combined with renal injury was analyzed by linear regression.The predictive value of MLB,Hcy and NGAL on acute cerebral infarction combined with renal injury was analyzed by ROC curve.【Results】Urine mALB,serum Hcy and NGAL levels and positive detection rate in the group A were significantly higher than those in the group B and the group C(P<0.05).Linear regression analysis showed that mALB,Hcy and NGAL levels were significantly correlated with acute cerebral infarction complicated with renal injury(P<0.05).ROC analysis showed that the area under ACU detected by combined detection was larger than that by single detection,and the combined detection could improve the prediction sensitivity and specificity(P<0.05).【Conclusion】The levels of urine mALB,serum Hcy and NGAL in patients with acute cerebral infarction complicated with renal injury were significantly increased,and they were positively correlated with renal injury.The combined detection of the three indexes has high value in the diagnosis of renal injury.

关 键 词：脑梗死 急性病 半胱氨酸/血液 

分 类 号：R743.33[医药卫生—神经病学与精神病学]