外周血sCysC联合尿uNAG对重症感染患者急性肾损伤的预测价值  

Predictive value of peripheral blood sCysC combined with uNAG for acute kidney injury in patients with severe infection

作　　者：冯海丽 王龙安[1] 杨蕾[1] 臧舒婷[1] 许丽君[1] 任莹[1] 刘亚楠 FENG Hai-li;WANG Long-an;YANG Lei;ZANG Shu-ting;XU Li-jun;REN Ying;LIU Yan-nan(Henan People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省人民医院急诊ICU,河南郑州450003

出　　处：《中华医院感染学杂志》2021年第4期539-543,共5页Chinese Journal of Nosocomiology

基　　金：河南省重点科技攻关基金资助项目(152102310150)。

摘　　要：目的探讨外周血胱抑素C(sCysC)联合尿N-乙酰-β-D-氨基葡萄糖苷酶(uNAG)对重症感染患者急性肾损伤(AKI)的预测价值。方法回顾性分析2019年1月-2020年3月河南省人民医院重症医学科(ICU)收治的300例重症感染患者的临床资料,患者依据KDIGO标准分为AKI组80例和非AKI组220例,对比其临床资料和sCysC、uNAG水平,并根据AKI严重程度将AKI组患者分为轻症AKI患者50例和重症AKI患者30例,对比两组sCysC、uNAG水平,采用受试者工作曲线(ROC)及曲线下面积(AUC)分析sCysC、uNAG对重症感染患者AKI及重症AKI的预测价值。结果 AKI组sCysC、uNAG分别为(0.91±0.18)mg/L、(3.85±0.92)Ummol/L高于非AKI组(P<0.001);重症AKI患者sCysC、uNAG分别为(1.06±0.14)mg/L、(5.32±0.79)Ummol/L高于轻症AKI组(P<0.001)。sCysC、uNAG单独及联合检测预测重症感染患者AKI的AUC分别为0.858、0.886、0.924,联合检测预测重症感染患者AKI的AUC大于单独检测(P<0.001)。sCysC、uNAG单独及联合检测预测重症感染患者重症AKI的AUC分别为0.727、0.833、0.886,联合检测预测重症感染患者重症AKI的AUC大于单独检测(P<0.001)。结论 sCysC、uNAG对重症感染患者AKI及重症AKI均有一定预测价值,且其联合检测对AKI及重症AKI的预测效能更高。OBJECTIVE To investigate the predictive value of peripheral blood cystatin C(sCysC) combined with urine N-acetyl-β-D-glucosaminidase(uNAG) for acute kidney injury(AKI) in patients with severe infection. METHODS The clinical data of 300 patients with severe infection admitted to the Intensive Care Unit(ICU) of Henan People’s Hospital from Jan. 2019 and Mar. 2020 were retrospectively analyzed. According to the KDIGO standard, the patients were divided into 80 cases of AKI group and 220 cases of non-AKI group. The clinical data, sCysC and uNAG levels were compared between the two groups. According to the severity of AKI, the patients in AKI group were divided into 50 cases of mild AKI group and 30 cases of severe AKI group. The sCysC and uNAG levels in the two groups were compared, and the receiver operating characteristic(ROC) curve and area under the curve(AUC) was used to analyze the predictive value of sCysC and uNAG for the severely infected patients with AKI and severe AKI. RESULTS The sCysC and uNAG levels in AKI group were(0.91±0.18) mg/L and(3.85±0.92) Ummol/L, respectively, significantly higher than those in non-AKI group(P<0.001). The sCysC and uNAG levels in severe AKI group were(1.06±0.14) mg/L,(5.32±0.79) Ummol/L, respectively, significantly higher than those in mild AKI group(P<0.001). The area under the curve(AUC) values of sCysC, uNAG alone and the combination of the two for predicting AKI in patients with severe infection were 0.858, 0.886 and 0.924, respectively. The AUC of combined detection was significantly greater than the single prediction(P<0.001). The AUC values of sCysC, uNAG alone and the combination of the two for predicting severe AKI in patients with severe infection were 0.727, 0.833 and 0.886, respectively. The AUC of combined detection was significantly greater than each index alone(P<0.001). CONCLUSION Both sCysC and uNAG have certain predictive value for AKI and severe AKI in severely infected patients, and their combined detection has higher predictive efficiency for AKI a

关 键 词：重症感染 急性肾损害 胱抑素 尿N-乙酰-Β-D-氨基葡萄糖苷酶 诊断 

分 类 号：R586.1+1[医药卫生—内分泌]