创伤性老年患者急性肾损伤的预测价值分析  

Analysis of the predictive value of acute kidney injury in elderly traumatic patients

作　　者：郭献阳[1] 王本极[1] 魏大臻[1] 陈如杰[1] GUO Xianyang;WANG Benji;WEI Dazhen(Second Affiliated Hospital,Wenzhou Medical University,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第二医院,温州325000

出　　处：《浙江创伤外科》2024年第5期803-805,共3页Zhejiang Journal of Traumatic Surgery

基　　金：温州市科技局基金项目(Y2020523)。

摘　　要：目的探讨几丁质酶3样蛋白1(CHI3L1)、中性粒细胞明胶酶相关脂质转载蛋白(NGAL)及N-乙酰-β-D-氨基葡萄糖苷酶(NAG)对老年创伤患者急性肾损伤(AKI)早期诊断的预测价值。方法老年创伤患者120例,在入科时收集血、尿标本,检测血清和尿CHI3L1、血清和尿NGAL、尿NAG浓度。每6 h记录尿量。入科同时检测血肌酐。采用logistic回归及ROC曲线分析CHI3L1、NGAL、NAG对老年AKI的预测作用。结果多因素logistic回归分析显示血清CHI3L1(SCHI3L1)与血清NGAL(SNGAL)是AKI发生的高危因素。ROC曲线显示预测老年创伤患者AKI的发生,SNGAL的AUC为0.819,SCHI3L1的AUC为0.729,SNGAL联合SCHI3L1的AUC为0.834。结论SCHI3L1与SNGAL是老年创伤患者AKI发生的高危因素,两者均可以预测其AKI的发生,以SNGAL的预测作用更明显,联合指标能提高预测准确率。Objective To explore the predictive value of chitinase 3-like protein 1(CHI3L1),neutrophil gelatinase associated lipid transfer protein(NGAL),and N-acetyl-β-D-glucosaminidase(NAG)in early diagnosis of elderly traumatic patients with acute kidney injury(AKI).Methods 120 elderly patients admitted to the Intensive Care Department were retrospectively studied.The blood and urine samples were collected.Blood and urine CHI3L1,blood and urine NGAL,urine NAG concentration and blood creatinine were examined after admission.The urine volume was recorded every 6 hours.The logistic regression analysis and ROC curve were used to predict the predictive effect of CHI3L1,NGAL,and NAG on elderly AKI.Results Multivariate logistic regression analysis showed that serum CHI3L1(SCHI3L1)and serum NGAL(SNGAL)were high-risk factors for the occurrence of AKI.The ROC curve predicts the occurrence of AKI in elderly critically ill patients,with an AUC of 0.819 for SNGAL,0.729 for SCHI3L1,and 0.834 for SNGAL combined with SCHI3L1.Conclusion Both of SCHI3L1 and SNGAL can predict the occurrence of AKI in elderly traumatic patients,with SNGAL having a more significant predictive effect.The combination of indicators can improve the accuracy of prediction.

关 键 词：几丁质酶3样蛋白1 中性粒细胞明胶酶相关脂质转载蛋白 N-乙酰-Β-D-氨基葡萄糖苷酶 老年 创伤 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]