摘要
目的利用受试者工作特征曲线(ROC)评价中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对重症急性胰腺炎(SAP)患者急性肾损伤(AKI)的预测价值。方法选取2015年6月-2019年6月江苏大学附属医院收治的SAP患者44例,根据入院1周内AKI发生情况,分为非AKI组(n=26)和AKI组(n=18)。在入院后均动态采集患者血液和尿液标本,检测患者血清NGAL(sNGAL)和尿液NGAL(uNGAL)含量。以AKI时间为节点,分析AKI发生前72 h内两组患者sNGAL和uNGAL水平的差异。同时绘制受试者工作特征曲线(ROC),评价sNGAL和uNGAL对SAP患者AKI的预测价值。结果在AKI发生前72、48、24 h和发生时合并AKI组患者sNGAL和uNGAL水平均显著高于非AKI患者,差异有统计学意义(P<0.05)。ROC曲线分析提示sNGAL和uNGAL均能有效预测AKI的发生,以AKI发生前24 h的sNGAL(AUC:0.94,95%CI:0.88~1.00)和uNGAL(AUC:0.92,95%CI:0.83~1.00)预测价值最高。结论早期检测SAP患者sNGAL和uNGAL水平能够有效预测AKI发生。
Objective To assess the predictive value of neutrophil gelatinase-associated lipocalin(NGAL) in early predicting acute kidney injury(AKI) in severe acute pancreatitis(SAP) patients.Methods From June 2015 through June2019,a prospective observational study of SAP patients without AKI was carried out in affiliated hospital of Jiangsu university,including 18 patients in the AKI group and 26 patients in the non-AKI group.Blood and urine samples were collected continuously.Serum NGAL(sNGAL) and urine NGAL(uNGAL) were detected.Patients were divided into AKI group and non-AKI group according to whether AKI occurred within 1 week after admission to the hospital.Differences in sNGAL and uNGAL contents between the 2 groups were compared.Receiver operating characteristic(ROC) curve was drawn to evaluate the predictive value of sNGAL and uNGAL in SAP patients with AKI.Results In this study,total of 44 SAP patients were enrolled.The basic data of the 2 groups were consistent.At 72 h,48 h,24 h before AKI,the levels of sNGAL and uNGAL of SAP patients in the AKI group were significantly higher than those in the non-AKI group(P<0.05).ROC.curve analysis suggested that both sNGAL and uNGAL could effectively predict the occurrence of AKI.The predictive values of sNGAL(AUC:0.94,95%CI:0.88-1.00) and uNGAL(AUC:0.92,95%CI:0.8-1.00) were the highest at 24 h before the occurrence of AKI.Conclusion Early detection of sNGAL and uNGAL in SAP patients could effectively predict the occurrence of AKI.
作者
刘大东
孙志伟
张德厚
LIU Da-dong;SUN Zhi-wei;ZHANG De-hou(Department of Critical Care Medicine,the Affiliated Hospital of Jiangsu University,Jiangsu,Zhenjiang 212000,China)
出处
《热带医学杂志》
CAS
2020年第12期1610-1613,F0003,共5页
Journal of Tropical Medicine
