尿中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子-1在流行性出血热合并急性肾损伤早期诊断中的价值研究

发布时间：2018-06-06 04:47

  本文选题：中性粒细胞明胶酶相关脂质运载蛋白 + 肾损伤分子-　； 参考：《中国全科医学》2017年31期

【摘要】：目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肾损伤分子-1(KIM-1)在流行性出血热(EHF)合并急性肾损伤(AKI)早期诊断中的价值。方法选取2014年1月—2016年11月济宁医学院附属医院肾内科、ICU、呼吸科及血液科收治的符合纳入排除标准的41例EHF患者。根据AKI的诊断标准,将患者分为非AKI组和AKI组,收集两组确诊时、确诊后不同时间点的血清肌酐(Scr)、尿NGAL、尿KIM-1水平。采用受试者工作特征(ROC)曲线评价尿NGAL和尿KIM-1对EHF合并AKI的早期诊断价值。结果 41例EHF患者中,合并AKI者26例(63.4%)。两组患者确诊时Scr、确诊时尿KIM-1水平比较,差异无统计学意义(P0.05);两组患者Scr水平在确诊后24、48、72 h比较,差异有统计学意义(P0.05);尿NGAL水平在确诊时及确诊后2、4、8、12、24h比较,差异有统计学意义(P0.05);尿KIM-1水平在确诊后2、4、8、12、24 h比较,差异有统计学意义(P0.05)。Pearson相关分析显示,确诊后2 h尿KIM-1水平、确诊后2 h尿NGAL水平与确诊后24 h Scr水平呈正相关(r值分别为0.673、0.846,P0.01)。确诊后2 h尿NGAL诊断EHF合并AKI的ROC曲线下面积为0.822[95%CI(0.692,0.952)],截点值为40.15 pg/ml;确诊后2 h尿KIM-1的曲线下面积为0.785[95%CI(0.643,0.927)],截点值为0.55 pg/ml。结论尿NGAL和尿KIM-1可能可以作为EHF患者是否合并AKI的早期诊断标志物。
[Abstract]:Objective to investigate the value of urinary neutrophil gelatinase-associated lipid carrier protein (NGALL) and renal injury molecule (-1) KIM-1 in the early diagnosis of acute renal injury (AKI) associated with epidemic hemorrhagic fever (EHF). Methods from January 2014 to November 2016, 41 patients with EHF who were admitted to Department of Renal Medicine, Department of Respiratory Medicine and Department of Hematology in affiliated Hospital of Jining Medical College were selected. According to the diagnostic criteria of AKI patients were divided into non-AKI group and AKI group. Serum creatinine (creatinine) urine KIM-1 levels were collected at different time points after diagnosis. The early diagnostic value of urine NGAL and urinary KIM-1 in EHF with AKI was evaluated by using the operating characteristics of subjects. Results among 41 patients with EHF, 26 cases were complicated with AKI. There was no significant difference in urine KIM-1 level between the two groups at the time of diagnosis and the level of urinary KIM-1 at the time of diagnosis (P 0.05), the level of Scr in the two groups was significantly higher than that in the control group at 24 h, 48 h after diagnosis, and the level of urinary NGAL was significantly higher than that in 24 h after diagnosis, and the level of urinary NGAL was compared between the two groups at the time of diagnosis and at 24 h after diagnosis. The difference was statistically significant (P 0.05) and the urinary KIM-1 level was significantly higher than that at 24 h after diagnosis (P 0.05). Pearson correlation analysis showed that there was a positive correlation between urinary KIM-1 level 2 h after diagnosis and 24 h Scr level at 24 h after diagnosis (r = 0.6730.846). At 2 h after diagnosis, the area under the ROC curve of EHF combined with AKI was 0.822 (95 CI 0.6920.9052), the cut-off point was 40.15 PG / ml, and the area under the curve of urine KIM-1 2 h after diagnosis was 0.785 [95CI0.643 卤0.927], and the cut-off point was 0.55 PG / ml. Conclusion urinary NGAL and urinary KIM-1 may be used as early diagnostic markers of AKI in EHF patients.
【作者单位】： 济宁医学院附属医院;
【基金】：济宁市科技发展计划项目(2014jnnk04)
【分类号】：R512.8;R692.5
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