人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值

发布时间：2018-02-16 02:00

本文关键词： 人中性粒细胞明胶酶相关性脂质运载蛋白脓毒症儿童急性肾损伤　出处：《第三军医大学学报》2017年02期 　论文类型：期刊论文

【摘要】：目的观察重症监护室(intensive care unit,ICU)中脓毒症患儿诊断急性肾损伤(acute kidney injury,AKI)前血浆及尿中人中性粒细胞明胶酶相关性脂质运载蛋白(neutrophil gelatinase associated lipocalin,NGAL)水平变化,并探讨其对脓毒症AKI预测诊断价值。方法纳入成都妇女儿童中心医院2013年7月至2016年7月ICU收治的150例肾功能正常脓毒症患儿。分别于患儿进入ICU时(D1)至第6天(D6)上午9时左右取患儿新鲜尿液及静脉血检测血浆及尿液中NGAL水平;入ICU时(D1)至第7天(D7)上午9时检测血清肌酐(serum creatinine,SCr)水平。根据全球改善肾脏病预后组织(KDIGO)2012年标准将脓毒症患儿分为AKI组和非AKI组;采用ROC曲线下面积(area under curve,AUC)分析患儿AKI诊断前72、48、24 h血浆及尿NGAL对AKI的预测诊断价值。结果 150例脓毒症患儿中,ICU 7 d内52例患儿诊断AKI,其发生率为34.6%;患儿AKI诊断前48、24 h尿和血浆中NGAL水平较诊断前72 h明显升高(P0.01);患儿AKI诊断前48 h及24 h尿NGAL预测诊断AKI的AUC分别为0.728,95%CI(0.630,0.825)和0.943,95%CI(0.903,0.983);诊断前24 h血浆NGAL预测诊断AKI的AUC为0.823,95%CI(0.751,0.895)。结论脓毒症AKI患儿尿液及血浆NGAL明显升高,其尿及血浆中NGAL水平升高对AKI具有中到高度的预测诊断价值。
[Abstract]:Objective to observe the changes of neutrophil gelatinase associated lipocalin NGALs in plasma and urine of children with sepsis in intensive care unit before diagnosis of acute renal injury. Methods 150 patients with normal renal function sepsis treated by ICU from July 2013 to July 2016 in Chengdu Women and Children's Central Hospital were enrolled in this study. After entering ICU, the patients were divided into two groups: D1) and D6 days. The fresh urine and venous blood were collected at 9:00 to detect the level of NGAL in plasma and urine. Serum creatinine creatinine (SCR) level was detected at 9:00. According to the global standard of improving prognosis of renal disease, children with sepsis were divided into AKI group and non-#en2# group according to 2012 standard. The area under ROC curve was used to analyze the predictive value of NGAL in plasma and urine for 24 hours before diagnosis of AKI in children with AKI. Results 52 of 150 children with sepsis were diagnosed by AUC within 7 days, the incidence rate was 34.6 and before diagnosis of AKI. The levels of NGAL in urine and plasma at 24 h after diagnosis were significantly higher than those in 72 h before diagnosis (P 0.01), the AUC of predictive diagnosis of AKI 48 h and 24 h before diagnosis of AKI by urinary NGAL were 0.72895% and 0.943 995% respectively) and 0.903 + 0.983C at 24 h before diagnosis, and the AUC of AKI predicted by plasma NGAL 24 hours before diagnosis was 0.823 95CIT 0.751T 0.8950.Conclusion AKI with sepsis can be diagnosed. The levels of NGAL in urine and plasma were significantly increased in children. Elevated levels of NGAL in urine and plasma are of medium to high predictive value for AKI.
【作者单位】：成都市妇女儿童中心医院儿童重症医学科;四川省人民医院儿科;
【分类号】：R720.597;R726.9

【相似文献】