摘要
目的探索尿微量清蛋白(mAlb)/肌酐(Cr)预测新生儿急性肾损伤(AKI)及预后的临床价值。方法对2016年1月至2019年1月该院新生儿重症监护室(NICU)的203例患儿临床资料进行分析,根据是否并发AKI分为AKI组和非AKI组,分析尿mAlb/Cr预测新生儿AKI发生的价值;同时根据患儿入住NICU期间存活情况分为存活组和死亡组,分析尿mAlb/Cr预测AKI病死率的价值。结果与非AKI组比较,AKI组胎龄、出生时体重更低,新生儿急性生理学(SNAP)评分、窒息率、呼吸窘迫综合征发生率、美罗培南使用率、机械通气率、吸氧率更高,差异有统计学意义(P<0.05)。多因素logistic回归分析显示SNAP评分(OR=1.307,95%CI:1.069~1.600)和尿mAlb/Cr(OR=26.128,95%CI:2.886~236.522)与AKI的发生相关。18例(8.87%)患儿最终死亡,其中AKI患儿14例(17.90%)。与死亡组比较,存活组胎龄和出生时体重更高,SNAP评分、窒息率、败血症发生率、呼吸窘迫综合征发生率、美罗培兰使用率、机械通气率、吸氧率、AKI发生率及尿mAlb/Cr更低,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线显示尿mAlb/Cr预测AKI的AUC值为0.794,临界值450.00μg/mgCr时,灵敏度和特异度分别为75.1%和75.9%。尿mAlb/Cr预测病死率的AUC值为0.814,临界值680.00μg/mgCr时,灵敏度和特异度分别为79.2%和73.1%。结论尿mAlb/Cr对于新生儿AKI及预后具有较好的预测价值。
Objective To explore the clinical value of urinary mAlb/Cr in predicting acute kidney injury in neonates and assessing prognosis.Methods The clinical data of 203 children in the neonatal intensive care unit(NICU)from January 2016 to January 2019 were analyzed.According to whether complicated with AKI,they were divided into the AKI group and the non-AKI group.The value of AKI occurred in children;at the same time,they were divided into the survival group and the death group according to their survival during NICU admission,and the value of urine mAlb/Cr to predict the mortality rate was analyzed.Results Compared with the non-AKI group,the AKI group had lower gestational age and birth weight,and the neonatal acute physiology(SNAP)score,asphyxia rate,respiratory distress syndrome incidence,meropenem use rate,mechanical ventilation rate,and oxygen absorption rate were higher,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that SNAP score(OR=1.307,95%CI:1.069-1.600)and urine mAlb/Cr(OR=26.128,95%CI:2.886-236.522)were associated with the occurrence of AKI.Eighteen children(8.87%)eventually died,including 14 children with AKI(17.90%).Compared with the death group,the surviving group had higher gestational age and birth weight,SNAP score,mechanical ventilation rate,oxygen absorption rate,asphyxia rate,sepsis rate,respiratory distress syndrome rate,AKI rate,meropenem use rate and urine mAlb/Cr were lower,the difference was statistically significant(P<0.05).ROC curve showed that the urinary mAlb/Cr predicted that AKI AUC value was 0.794,the critical value was 450.00μg/mgCr,the sensitivity and specificity was 75.1%and 75.9%,respectively.The urinary mAlb/Cr predicted fatality rate AUC was 0.814,the critical value was 680.00μg/mgCr,the sensitivity and specificity was 79.2%and 73.1%,respectively.Conclusion Urine mAlb/Cr has good predictive value for neonatal AKI and prognosis.
作者
孟宪坤
徐玉玲
董嘉良
MENG Xiankun;XU Yuling;DONG Jialiang(Department of Pediatrics,Ninghe District Hospital,Tianjin 301500,China;Department of Clinical Laboratory,Ninghe District Hospital,Tianjin 301500,China)
出处
《重庆医学》
CAS
2020年第16期2732-2736,共5页
Chongqing medicine
关键词
尿微量清蛋白
肌酐
婴儿
新生
疾病
急性肾损伤
预后
urinary microalbumin
creatinine
infant
newborn
diseases
acute kidney injury
prognosis
