摘要
目的:探讨尿中性粒细胞明胶酶相关载脂蛋白(neutrophil gelatinase-associated lipocalin,NGAL)、尿肾损伤分子-1(kidneyinjury molecule-1,Kim-1)、尿N-乙酰-β-D-氨基葡萄糖苷酶(N-acecyl-β-D-glucosaminidase,NAG)、尿微量白蛋白(mALB)在重症感染中合并急性肾损伤的敏感性及临床价值。方法:回顾分析60例在新疆自治区人民医院ICU住院的重症感染合并急性肾损伤(AKI)患者的尿NGAL、Kim-1、NAG及mALB的变化情况。健康体检者20例为对照组。尿NGAL、Kim-1、mALB测定采用酶联免疫法(ELISA)检测,尿NAG测定采用对硝基苯酚(PNP)比色法检测,并以ROC曲线分析其敏感性。结果:AKI组患者尿液中的NGAL、Kim-1、NAG、mALB的测定浓度明显高于对照组,差异具有统计学意义(P<0.001),通过ROC曲线、诊断试验结果显示:尿NGAL、Kim-1曲线下面积分别为0.986、0.956,95%可信区间分别是0.968～1.004、0.910～1.001,较尿NAG、mALB更具有敏感性(P<0.001)。结论:尿NGAL、尿Kim-1的浓度检测对重症感染合并急性肾损伤的诊断更具有敏感性,与NAG、mALB联合检测有助于急性肾损伤的早期监测,对预防急性肾损伤的发生、发展具有重要的临床价值。
Objective： To explore the sensitivity and clinical value of urine neutrophil gelatinase-associated lipocalin（NGAL）,kidney injury molecule-1（Kim-1）,urine N-acetyl-beta-D-glucosaminidase（NAG） and urine microalbumin（mALB） in patients of severe infection with acute kidney injury.Methods： Retrospectively analysis the changes of urine NGAL,urine Kim-1,urine NAG and urine mALB in 60 cases of severe infection with acute kidney injury who hospitalized in ICU.20 healthy subjects as control group.The urine NGAL,urine Kim-1 and urine mALB were respectively determined by enzyme linked immunosorbent assay（ELISA）,Urine NAG was measured by p-nitropheno（PNP） colorimetric assay,the sensitivity was analyzed by ROC curves.Results： Urine NGAL,Urine Kim-1,urine NAG and urine mALB were significantly higher in AKI group,compared with control group,there were statistically significances between AKI group and control group（P〈0.001）.Through the ROC curve and diagnostic test,the results showed that,the area under the curve of urine NGAL and urine Kim-1 were 0.986,0.956.the 95% confidence interval of urine NGAL and urine Kim-1 were 0.968-1.004,0.910-1.001.urine NGAL and urine Kim-1were more sensitive than urine NAG and urine mALB（P〈0.001）.Conclusions： Urine NGAL and urine Kim-1 had more diagnosis sensitivity for patients of severe infection with acute kidney injury.Combined detection of urine NGAL,urine Kim-1,urine NAG and urine mALB were helpful for early diagnosis of acute kidney injury,and had important clinical value on the prevention in pathogenesis and development of acute kidney injury.
出处
《现代生物医学进展》
CAS
2012年第13期2535-2538,共4页
Progress in Modern Biomedicine
基金
新疆维吾尔自治区人民医院课题资助(20100118)
