血清NT-proBNP、尿液NGAL对脓毒血症患儿继发急性肾损伤的早期预测价值

发布时间：2018-10-25 07:14

【摘要】：目的探讨血清N末端B型利钠肽前体(NT-proBNP)、尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对脓毒血症患儿继发急性肾损伤的早期预测价值。方法选择脓毒血症患儿126例,根据是否出现急性肾损伤分为急性肾损伤组42例和非急性肾损伤组84例,观察两组入组0、2、6、12、24、48、72 h时血清NT-proBNP、肌酐(Scr)及尿液NGAL水平变化。采用受试者工作特征(ROC)曲线评价血清NT-proBNP、尿液NGAL对脓毒血症患儿继发急性肾损伤的早期预测价值。结果急性肾损伤组入组6 h时血清NT-proBNP和尿液NGAL水平较入组0 h时明显升高,入组24 h时Scr水平较入组0 h时明显升高(P均0.05);非急性肾损伤组血清NT-proBNP、Scr及尿液NGAL水平各时点均未见明显变化(P均0.05)。入组6 h血清NT-proBNP诊断脓毒血症患儿继发急性肾损伤的ROC曲线下面积为0.719(95%CI:0.669~0.767,P0.01),以其cut off值(0.87 ng/m L)为截断值,血清NT-proBNP预测脓毒血症患儿继发急性肾损伤的敏感性为86.9%、特异性为85.8%;入组6 h尿液NGAL诊断脓毒血症患儿继发急性肾损伤的ROC曲线下面积为0.820(95%CI:0.775~0.869,P0.01),以其cut off值(95 ng/m L)为截断值,尿液NGAL预测脓毒血症患儿继发急性肾损伤的敏感性为88.9%、特异性为84.7%。结论血清NT-proBNP、尿液NGAL可用于早期预测脓毒血症患儿继发急性肾损伤。
[Abstract]:Objective to investigate the early predictive value of serum N-terminal B-type natriuretic peptide precursor (NT-proBNP) and urine neutrophil gelatinase-associated lipid carrier protein (NGAL) in children with sepsis. Methods 126 children with sepsis were divided into acute renal injury group (n = 42) and non-acute renal injury group (n = 84) according to whether acute renal injury occurred. The changes of serum NT-proBNP, creatinine (Scr) and urine NGAL levels were observed at 72 h. The early predictive value of serum NT-proBNP, urine NGAL for secondary acute renal injury in children with sepsis was evaluated by (ROC) curve. Results the levels of serum NT-proBNP and urine NGAL in acute renal injury group at 6 h were significantly higher than those in 0 h group. The level of Scr at 24 h was significantly higher than that at 0 h (all P 0. 05), and the levels of serum NT-proBNP,Scr and urine NGAL in non acute renal injury group were not significantly changed at each time point (P 0. 05). The area under the ROC curve of serum NT-proBNP for diagnosis of secondary acute renal injury in children with sepsis at 6 hours was 0.719 (95 CI: 0.669U 0.767p 0.01), and its cut off value (0.87 ng/m L) was used as truncation value. The sensitivity and specificity of serum NT-proBNP in predicting secondary acute renal injury in children with sepsis were 86.9 and 85.8 respectively, and the area under ROC curve of urine NGAL for diagnosis of secondary renal injury in children with sepsis was 0.820 (95CI: 0.7750.869 P0.01), and its cut off value (95 ng/m L) was used as truncation value. The sensitivity and specificity of urine NGAL in predicting secondary acute renal injury in children with sepsis were 88. 9 and 84. 7 respectively. Conclusion Serum NT-proBNP, urine NGAL can be used for early prediction of secondary acute renal injury in children with sepsis.
【作者单位】：聊城市第二人民医院;重庆医科大学附属第一医院第一分院;
【基金】：重庆市卫生和计划生育委员会医学科研面上项目(2015-MSXM001)
【分类号】：R720.597

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