尿肝型脂肪酸结合蛋白对肺移植术后急性肾损伤的早期诊断及进展判断

发布时间：2018-05-27 12:21

本文选题：急性肾损伤 + 肺移植　；参考：《实用医学杂志》2017年01期

【摘要】：目的:探讨尿肝型脂肪酸结合蛋白(L-FABP)在肺移植术后急性肾损伤(AKI)早期诊断及预测进展中的价值。方法:收集行肺移植手术患者围手术期尿液和血液标本,分别检测尿L-FABP和血肌酐(Scr)。根据KDIGO标准中Scr标准将患者分为AKI组和非AKI组。观察两组各时间点尿L-FABP和Scr水平动态变化。结果:119例患者中57例术后发生AKI。两组术后即刻至48 h尿L-FABP均显著升高,其中6~48 h两组间差异有统计学意义。在诊断价值上,尿L-FABP术后6 h的ROC曲线下面积(AUC)为0.818,取2 254.52 ng/mg Cr为AKI诊断截点时,其诊断AKI的敏感性和特异性为0.782和0.814;在预测AKI进展上,尿L-FABP术后6 h的ROC下AUC为0.852,取4313.17 ng/mg Cr为AKI诊断截点时,预测AKI进展的敏感性和特异性为0.867和0.700。结论:尿L-FABP在肺移植术后早期诊断及预测AKI进展上表现出较高的敏感性和特异性,也许能作为AKI早期诊断并判断其进展趋势的生物学标志物。
[Abstract]:Objective: to investigate the value of urine liver-type fatty acid binding protein L-FABPin in early diagnosis and prediction of acute renal injury (AKI) after lung transplantation. Methods: urine and blood samples were collected from patients undergoing lung transplantation. Urine L-FABP and creatinine were detected respectively. Patients were divided into AKI group and non-AKI group according to Scr standard in KDIGO standard. The dynamic changes of urinary L-FABP and Scr were observed at different time points in both groups. Results among 119 cases, 57 cases developed AKI after operation. Urinary L-FABP was significantly increased in the two groups from immediately to 48 hours after operation, and there was a significant difference between the two groups at 6 and 48 hours. In the diagnostic value, the area under the ROC curve at 6 hours after L-FABP was 0.818. When 2 254.52 ng/mg Cr was taken as the diagnostic cut-off point of AKI, the sensitivity and specificity of AKI were 0.782 and 0.814, respectively. The AUC under ROC at 6 hours after L-FABP was 0.852. The sensitivity and specificity of AKI progression were 0.867 and 0.700 when 4313.17 ng/mg Cr was taken as the diagnostic cut-off point of AKI. Conclusion: urinary L-FABP has a high sensitivity and specificity in early diagnosis and prediction of AKI progression after lung transplantation. It may be used as a biomarker for early diagnosis and evaluation of AKI progression.
【作者单位】：南京医科大学附属无锡市人民医院肾脏科;
【基金】：无锡市科技发展指导性计划项目(CSZ00N1207)
【分类号】：R655.3;R692.5

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