中性粒细胞明胶酶相关脂质运载蛋白、肾损伤分子-1联合尿微量白蛋白检测对胰腺炎并发急性肾损伤的诊断价值  

Diagnostic value of neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 combined with urinary microscale albuminuria in pancreatitis complicated with acute kidney injury

作　　者：肖礼红 鲁力 石伟 XIAO Lihong;LU Li;SHI Wei(Department of Laboratory,Beijing Jishuitan Hospital Guizhou Hospital,Guizhou Province,Guiyang 550014,China)

机构地区：[1]北京积水潭医院贵州医院检验科,贵州贵阳550014

出　　处：《中国当代医药》2024年第11期117-120,共4页China Modern Medicine

摘　　要：目的分析尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)联合尿微量白蛋白(MAU)检测在急性胰腺炎(AP)并发急性肾损伤(AKI)早期诊断中的价值。方法选取2020年7月至2023年7月北京积水潭医院贵州医院收治的120例AP患者作为研究对象,根据入院后7 d内是否发生AKI分为AKI组、非AKI组,患者均于入院当日采集尿液,检测NGAL、KIM-1、MAU水平。比较两组患者一般资料及尿液NGAL、KIM-1、MAU水平,分析NGAL、KIM-1和MAU水平与急性生理学和慢性健康评估Ⅱ(APACHEⅡ)评分的相关性,采用受试者工作特征曲线(ROC)评估NGAL、KIM-1和MAU单独及联合检测对AP并发AKI的预测价值。结果两组患者年龄、性别、体重指数(BMI)、糖尿病史、高血压史、发病至入院时间、基线血肌酐水平比较,差异均无统计学意义(P>0.05);AKI组APACHEⅡ评分高于非AKI组,差异有统计学意义(P<0.05);AKI组尿液NGAL、KIM-1、MAU水平均高于非AKI组,差异有统计学意义(P<0.05);Pearson相关性分析显示,尿液NGAL、KIM-1、MAU水平与APACHEⅡ评分均呈正相关(P<0.05);ROC曲线显示,尿液NGAL、KIM-1、MAU预测AP并发AKI的最佳截断值分别为158.50 ng/ml、3.23 ng/ml和23.85 mg/L,对应的AUC分别为0.872、0.853和0.841,联合诊断AUC为0.912。结论尿液NGAL、KIM-1和MAU检测对AP并发AKI具有较高的预测价值,可提高早期诊断效能。Objective To analyze the value of urine neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1)and urinary microscale albuminuria(MAU)detection in the early diagnosis of acute pancreatitis(AP)complicated with acute kidney injury(AKI).Methods A total of 120 AP patients admitted to Beijing Jishuitan Hospital Guizhou Hospital from July 2020 to July 2023 were selected as the research objects.According to whether AKI occurred within 7 d after admission,they were divided into AKI group and non-AKI group.Urine was collected on the day of admission and NGAL,KIM-1 and MAU levels were detected.The general data and urine NGAL,KIM-1 and MAU levels of the two groups were compared,and the correlation between NGAL,KIM-1 and MAU levels and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores were analyzed.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of NGAL,KIM-1 and MAU alone and in combination for AP complicated with AKI.Results There were no significant differences in age,sex,body mass index(BMI),history of diabetes,history of hypertension,time from onset to admission,and baseline serum creatinine level between two groups(P>0.05).The APACHEⅡscore in AKI group was higher than that in non-AKI group,and the difference was statistically significant(P<0.05).The levels of urine NGAL,KIM-1 and MAU in AKI group were higher than those in non-AKI group,with statistical significances(P<0.05).Pearson correlation analysis showed that urine NGAL,KIM-1 and MAU levels were positively correlated with APACHEⅡscores(P<0.05).ROC curve showed that the best cutoff values of urine NGAL,KIM-1 and MAU for predicting AP concurrent AKI were 158.50 ng/ml,3.23 ng/ml and 23.85 mg/L,respectively,the corresponding AUC were 0.872,0.853 and 0.841,and the AUC for combined diagnosis was 0.912.Conclusion Urine NGAL,KIM-1 and MAU detection have high predictive value for AP complicated with AKI,and can improve the early diagnosis efficiency.

关 键 词：急性胰腺炎 急性肾损伤 中性粒细胞明胶酶相关脂质运载蛋白 肾损伤分子-1 尿微量白蛋白 诊断价值 

分 类 号：R576[医药卫生—消化系统]