Cr和NGAL预测老年重度烧伤患者早期急性肾损伤的应用价值  

Application Value of Serum Creatinine and Neutrophil Gelatinase-associated Lipocalin in Predicting Early Acute Kidney Injury in Elderly Patients with Severe Burn

作　　者：杨佳伟[1] 田野[1] 蒲丹[1] 任天水 刘金宝 YANG Jiawei;TIAN Ye;PU Dan;REN Tianshui;LIU Jinbao(Jilin Provincial Armed Police Corps Hospital,Changchun 130052,China)

机构地区：[1]武警吉林省总队医院,吉林长春130052

出　　处：《北华大学学报（自然科学版）》2024年第4期477-481,共5页Journal of Beihua University（Natural Science）

基　　金：吉林省科技发展计划项目(20210201033LC)。

摘　　要：目的 探讨肌酐(Cr)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)预测老年重度烧伤患者早期急性肾损伤的应用价值。方法 选取53例老年烧伤患者,烧伤面积均大于20%,根据是否发生急性肾损伤(AKI)将患者分为AKI组(28例)及非AKI组(25例),在入院后的48 h内,每6 h收集1次全血NGAL和Cr的测量值。应用氧化酶法测定血清Cr水平;应用酶联免疫吸附法测定NGAL水平;利用受试者工作曲线(ROC)计算曲线下面积(AUC),比较各指标的诊断能力。结果 AKI组患者烧伤面积明显高于非AKI组患者(P<0.01);年龄、平均动脉压、中心静脉压、尿量在两组患者间比较差异无统计学意义(P>0.05)。AKI组患者6 h血NGAL水平明显高于非AKI组患者(P<0.01);AKI组患者12、24 h血NGAL、Cr水平明显高于非AKI组患者(P<0.01、P<0.05)。构建ROC曲线结果显示,血清Cr、血NGAL截断值为86.08μmol/L、125.75 ng/mL时对烧伤患者AKI具有较高的预测价值,其中,血NGAL水平预测烧伤患者AKI的灵敏度、阳性预测值更高。结论 入院48 h内测量血NGAL水平可以预测老年重度烧伤患者是否发生AKI,相较于血清Cr水平,血NGAL水平表现出更高的预测价值。Objective Exploring the application value of creatinine(Cr)and neutrophil gelatinase-associated lipid transport protein(NGAL)in predicting early acute kidney injury in elderly patients with severe burns.Method 53 elderly burn patients were selected,all with burn areas greater than 20%.Patients were divided into AKI group(28 cases)and non-AKI group(25 cases)based on whether AKI occurred.Within 48 hours after admission,whole blood NGAL and Cr measurements were collected every 6 hours.The determination of serum Cr was carried out by using the oxidase method.The determination of NGAL was carried out by using commercially available enzyme-linked immunosorbent assay.And use the receiver operating curve(ROC)to calculate the area under the curve(AUC),compare the diagnostic ability of indicators.Results The burn area of patients in AKI group was significantly higher than that of non-AKI group patients(P<0.01);There was no statistically significant difference in age,mean arterial pressure,central venous pressure,and urine output of patients between the two groups(P>0.05).The serum NGAL levels of patients in AKI group were significantly higher than those in non-AKI group at 6 hours(P<0.01);The serum NGAL and Cr levels in AKI group were significantly higher than those of non-AKI group at 12 hours,24 hours(P<0.01,P<0.05).The results of constructing ROC curves show that the cut-off values of serum Cr and blood NGAL are 86.08μmol/L and 125.75 ng/mL have high predictive value for AKI in burn patients,with higher sensitivity and positive predictive value of blood NGAL in predicting AKI in burn patients.Conclusion Plasma NGAL levels measured within 48 hours of admission can predict AKI in elderly patients with severe burns,and serum NGAL can show higher predictive value than serum Cr.

关 键 词：重度烧伤 老年人 急性肾损伤 肌酐 中性粒细胞明胶酶相关脂质运载蛋白 预测价值 

分 类 号：R644[医药卫生—外科学]