尿NAG、血PCT及SOFA评分对脓毒症患者急性肾损伤的预测价值  

Predictive value of urine NAG, serum PCT and SOFA score in the prediction of acute kidney injury in sepsis patients

作　　者：董照刚[1] 郑喜胜[1] 贾明雅[1] 李长力[1] 肖京[1] DONG Zhao-gang;ZHENG Xi-sheng;JIA Ming-ya;LI Chang-li;XIAO Jing(Nanyang Ceritral Hospital,Nanyang Henan 473009,China)

机构地区：[1]南阳市中心医院重症医学科,河南南阳473009

出　　处：《中华医院感染学杂志》2020年第23期3534-3538,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关基金资助项目(2018020504)。

摘　　要：目的探讨尿N-乙酰-β-D-葡萄糖苷酶(NAG)、血降钙素原(PCT)及序贯器官衰竭评分(SOFA)对脓毒症患者急性肾损伤(AKI)的预测价值。方法回顾性分析2016年12月-2018年12月在南阳市中心医院重症医学科收治的79例脓毒症患者,根据患者是否合并AKI分为AKI组51例和非AKI组28例。酶联免疫检测法检测血清PCT水平;采用Logistic分析影响脓毒症患者AKI发生的危险因素;Pearson相关性分析尿NAG、血PCT及SOFA评分与脓毒症合并AKI患者KDICO分期的相关性;ROC分析尿NAG、血PCT及SOFA评分对脓毒症患者AKI的预测价值,曲线下面积(AUC)表示预测价值。结果尿NAG、SOFA评分以及PCT为影响脓毒症患者并发AKI的独立影响因素(P<0.05);尿NAG、血PCT和SOFA评分与AKI患者KDICO分级呈显著正相关关系(P<0.001);尿NAG、血PCT、SOFA评分以及三者联合检测预测脓毒症患者AKI的AUC依次为0.819、0.748、0.721、0.914。结论尿NAG对脓毒症患者AKI的预测价值最高,联合血PCT和SOFA评分可进一步提高其预测价值。OBJECTIVE To explore the predictive value of urine N-acetyl-beta-D-glucusamidase(NAG), serum procalcitonin(PCT) and sequential organ failure assessment(SOFA) score for acute kidney injury(AKI) in sepsis patients. METHODS A retrospective analysis was performed on 79 sepsis patients, who were admitted to the department of critical care medicine, Nanyang Central Hospital from Dec. 2016 to Dec. 2018. According to presence or absence of AKI, they were divided into the AKI group(n=51) and non-AKI group(n=28). The enzyme linked immunosorbent assay(ELISA) was applied to detect the serum PCT level. Logistic analysis was applied to analyze risk factors of AKI in sepsis patients. Pearson correlation analysis was applied to analyze the correlation between urine NAG, serum PCT and SOFA score and KDICO staging in patients with sepsis and AKI. ROC analysis was applied to analyze predictive value of urine NAG, serum PCT and SOFA score for AKI in sepsis patients. The area under the curve(AUC) indicated the predictive value. RESULTS Urine NAG, SOFA score and PCT were independent factors influencing AKI in sepsis patients(P<0.05). Urine NAG, serum PCT and SOFA score were positively correlated with KDICO grading in AKI patients(P<0.001). AUCs of urine NAG, serum PCT, SOFA score and their combined detection for predicting AKI in sepsis patients were 0.819, 0.748, 0.721 and 0.914, respectively. CONCLUSION The predictive value of urine NAG was the highest for AKI injury in sepsis patients, which combined with serum PCT and SOFA score can further improve the predictive efficiency.

关 键 词：尿N-乙酰-β-D-葡萄糖苷酶 血降钙素原 序贯器官衰竭评分 脓毒症 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]