尿L-FABP与尿NGAL联合应用在儿童心脏术后急性肾损伤早期诊断中的价值
发布时间：2018-12-08 17:58
【摘要】：目的探讨尿肝型脂肪酸结合蛋白(L-FABP)与尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合应用在儿童心脏术后急性肾损伤(AKI)早期诊断中的价值。方法以需建立体外循环(CPB)的97例先天性心脏病儿童为研究对象,收集其心脏手术前及术后不同时间点的血尿标本,分别测定血清肌酐(Scr)、尿L-FABP和尿NGAL水平,并比较AKI组(n=18)和非AKI组(n=79)患儿术后各标志物的动态变化。应用受试者工作特征(ROC)曲线及曲线下面积(AUC)评估标志物单独及其联合应用在预测术后AKI发生中的作用。结果 AKI组患儿尿L-FABP和尿NGAL水平在术后2 h、6 h均显著高于非AKI组,其浓度变化明显早于Scr的升高。尿L-FABP在术后2 h、6 h单独预测AKI发生的AUC分别为0.921和0.896;尿NGAL在术后2 h、6 h单独预测AKI发生的AUC分别为0.908和0.928。术后2 h及6 h尿L-FABP及NGAL联合应用预测术后AKI发生的AUC分别为0.942和0.929。结论尿L-FABP和尿NGAL在儿童心脏术后AKI早期即显著升高,明显早于Scr的改变,可早期预测AKI的发生,而两者联合应用可使诊断的精确性进一步提高。
[Abstract]:Objective to investigate the value of urinary hepatic fatty acid binding protein (L-FABP) combined with urinary neutrophil gelatinase-associated lipid carrier protein (NGAL) in early diagnosis of acute renal injury in children after cardiac surgery. Methods 97 children with congenital heart disease who needed to establish cardiopulmonary bypass (CPB) were studied. Serum creatinine (Scr), urine L-FABP and urinary NGAL were measured before and after cardiopulmonary bypass (CPB). The dynamic changes of markers in AKI group (nm18) and non-AKI group (nm79) were compared. (ROC) curve and area under the curve were used to evaluate the role of markers alone and combined in predicting the occurrence of postoperative AKI. Results the levels of urinary L-FABP and urinary NGAL in AKI group were significantly higher than those in non-AKI group at 2 h and 6 h after operation, and the change of urinary L-FABP and NGAL was earlier than that of Scr. The AUC of urine L-FABP was 0.921 and 0.896 respectively, and the AUC of urine NGAL was 0.908 and 0.928 respectively at 2 hours and 6 hours after operation. The combined use of urinary L-FABP and NGAL at 2 h and 6 h postoperatively predicted the incidence of AKI in 0.942 and 0.929 respectively. Conclusion urinary L-FABP and urinary NGAL increased significantly at the early stage of AKI after cardiac surgery in children, which was significantly earlier than that of Scr, which could predict the occurrence of AKI in the early stage, and the accuracy of diagnosis could be further improved by combined use of the two methods.
【作者单位】： 中南大学湘雅医院肾内科;
【基金】：国家自然科学基金资助(81500559)
【分类号】：R726.5
[Abstract]:Objective to investigate the value of urinary hepatic fatty acid binding protein (L-FABP) combined with urinary neutrophil gelatinase-associated lipid carrier protein (NGAL) in early diagnosis of acute renal injury in children after cardiac surgery. Methods 97 children with congenital heart disease who needed to establish cardiopulmonary bypass (CPB) were studied. Serum creatinine (Scr), urine L-FABP and urinary NGAL were measured before and after cardiopulmonary bypass (CPB). The dynamic changes of markers in AKI group (nm18) and non-AKI group (nm79) were compared. (ROC) curve and area under the curve were used to evaluate the role of markers alone and combined in predicting the occurrence of postoperative AKI. Results the levels of urinary L-FABP and urinary NGAL in AKI group were significantly higher than those in non-AKI group at 2 h and 6 h after operation, and the change of urinary L-FABP and NGAL was earlier than that of Scr. The AUC of urine L-FABP was 0.921 and 0.896 respectively, and the AUC of urine NGAL was 0.908 and 0.928 respectively at 2 hours and 6 hours after operation. The combined use of urinary L-FABP and NGAL at 2 h and 6 h postoperatively predicted the incidence of AKI in 0.942 and 0.929 respectively. Conclusion urinary L-FABP and urinary NGAL increased significantly at the early stage of AKI after cardiac surgery in children, which was significantly earlier than that of Scr, which could predict the occurrence of AKI in the early stage, and the accuracy of diagnosis could be further improved by combined use of the two methods.
【作者单位】： 中南大学湘雅医院肾内科;
【基金】：国家自然科学基金资助(81500559)
【分类号】：R726.5
【相似文献】
相关期刊论文 前10条
1 蒋秀娣;邵韵;;H-FABP检测在急性心肌梗死早期诊断中的临床应用[J];放射免疫学杂志;2013年01期
2 董美玲;王世东;孙臣忠;张庆华;许秀荷;张菊芳;周晓燕;程f，
本文编号：2368761
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2368761.html
最近更新
教材专著
