尿NGAL、NAG及血清Cys-C、钠离子联合检测在肝肾综合征早期的预测价值  

Predictive value of combined detection of urine NGAL,NAG,and serum Cys-C and sodium in the early stage of hepatorenal syndrome

作　　者：陈岩[1] 高巍[1] 朱大勇[2] CHEN Yan;GAO Wei;ZHU Da-yong(Infection of Internal Medicine,Heilongjiang Provincial Hospital,Haerbin Heilongjiang 150036,China;Department of General Surgery,Heilongjiang Provincial Hospital,Haerbin Heilongjiang 150036,China)

机构地区：[1]黑龙江省医院感染内科,黑龙江哈尔滨150036 [2]黑龙江省医院普外科,黑龙江哈尔滨150036

出　　处：《临床和实验医学杂志》2025年第3期237-241,共5页Journal of Clinical and Experimental Medicine

基　　金：2023年度黑龙江省卫生健康委科技计划项目(编号:20230303130414)。

摘　　要：目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、N-乙酰-β-葡萄糖苷酶(NAG)及血清胱抑素C(Cys-C)、钠离子联合检测在肝肾综合征(HRS)早期的预测价值。方法回顾性分析2023年1月至2024年1月黑龙江省医院收治的82例肝硬化失代偿期患者的临床资料,根据患者是否合并HRS分组,分为合并组(n=25)与未合并组(n=57)。比较两组患者一般资料[性别、年龄、体重指数、肝硬化病因、肝硬化病程、肝功能Child-Pugh分级占比及红细胞计数(RBC)、白细胞计数(WBC)、血红蛋白、血小板计数(PLT)水平]以及尿NGAL、NAG、血清Cys-C、钠离子水平。通过多因素采取非条件Logistic逐步回归分析明确肝硬化失代偿期患者早期合并HRS的危险因素。通过受试者操作特征(ROC)曲线分析尿NGAL、NAG及血清Cys-C、钠离子水平预测肝硬化失代偿期患者早期合并HRS的价值。结果两组患者性别、年龄、体重指数、肝硬化病因、肝硬化病程、肝功能Child-Pugh分级占比及RBC、WBC、血红蛋白、PLT水平比较,差异均无统计学意义(P>0.05);合并组的尿NGAL、NAG及血清Cys-C水平分别为(25.79±5.29)μg/L、(18.79±2.92)U/L、(2.12±0.19)mg/L,均高于未合并组[(12.15±3.29)μg/L、(11.45±2.65)U/L、(1.61±0.12)mg/L],血清钠离子水平为(133.68±2.52)mmol/L,低于未合并组[(137.71±2.75)mmol/L],差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,尿NGAL、NAG及血清Cys-C、钠离子水平均是肝硬化失代偿期患者早期合并HRS的危险因素(P<0.05)。经ROC曲线分析证实,尿NGAL、NAG及血清Cys-C、钠离子水平均可用于肝硬化失代偿期患者早期合并HRS的预测,曲线下面积分别为0.768、0.944、0.795、0.888,均有较好的预测价值(P<0.05)。结论肝硬化失代偿期患者早期合并HRS受尿NGAL、NAG及血清Cys-C、钠离子水平影响,在该疾病治疗期间临床医师应密切监测上述指标。Objective To investigate the predictive value of combined detection of urinary neutrophil gelatinase-associated lipocalin(NGAL),N-acetyl-β-glucosaminidase(NAG),serum cystatin C(Cys-C)and sodium ion in the early stage of hepatorenal syndrome(HRS).Methods A retrospective analysis was conducted on the clinical data of 82 patients with decompensated liver cirrhosis admitted to Heilongjiang Provincial Hospital from January 2023 to January 2024.According to whether patients had HRS,they were divided into the combined group(n=25)and the non-combined group(n=57).The general data[gender,age,body mass index,etiology of cirrhosis,course of cirrhosis,proportion of Child-Pugh classification of liver function,red blood cell count(RBC),white blood cell count(WBC),hemoglobin and platelet count(PLT)levels],urinary NGAL,NAG,serum Cys-C and sodium ion levels were compared between the two groups.The risk factors of early HRS in patients with decompensated cirrhosis were identified by multivariate unconditional Logistic stepwise regression analysis.The value of urinary NGAL,NAG,serum Cys-C and sodium ion levels in predicting early HRS in patients with decompensated cirrhosis was analyzed by receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in gender,age,body mass index,etiology of cirrhosis,course of cirrhosis,proportion of Child-Pugh classification of liver function and levels of RBC,WBC,hemoglobin and PLT between the two groups(P>0.05).The levels of urinary NGAL,NAG and serum Cys-C in the combined group were(25.79±5.29)μg/L,(18.79±2.92)U/L and(2.12±0.19)mg/L,respectively,which were higher than those in the non-combined group[(12.15±3.29)μg/L,(11.45±2.65)U/L,(1.61±0.12)mg/L],the serum sodium ion level was(133.68±2.52)mmol/L,which was lower than that in the non-combined group[(137.71±2.75)mmol/L],the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that urinary NGAL,NAG,and serum Cys-C,sodium ion levels w

关 键 词：肝肾综合征 中性粒细胞明胶酶相关脂质运载蛋白 N-乙酰-β-葡萄糖苷酶 胱抑素C 钠离子 肝硬化失代偿期 

分 类 号：R692[医药卫生—泌尿科学] R575.2[医药卫生—外科学]