血脂质运载蛋白、CysC检测在急性肾损伤患者早期诊断的应用

Application of blood NGAL, CysC detection in early diagnosis of acute kidney injury

目的观察血中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血清半胱氨酸蛋白酶抑制剂C(CysC)水平检测在急性肾损伤(AKI)患者早期诊断的应用。方法选择该院重症加强护理病房(ICU)符合急性肾损伤诊断的患者92例作为研究组,根据诊断将其中79例作为存活组,另外13例作为死亡组,并将同期非急性肾损伤患者30例作为对照组,于入院时行血NGAL、CysC检测,并与血尿素氮(BUN)及血清肌酐(Scr)水平进行分析。结果存活组与死亡组入ICU时NGAL、CysC水平明显高于对照组(P<0.05)。死亡组入ICU时BUN和Scr水平明显高于对照组和存活组(P<0.05)。存活组与对照组BUN和Scr水平比较差异无统计学意义(P>0.05)。入院第3天AKI患者NGAL、CysC、BUN和Scr水平持续升高,与对照组比较差异有统计学意义(P<0.05)。入院7、14 d,NGAL、CysC水平呈下降趋势,而7 d时BUN和Scr水平持续升高,14 d呈下降趋势。NGAL截断值为46.29μg/L,敏感性和特异性分别为85.2%和95.4%;CysC截断值为1.31μmol/L,敏感性和特异性分别为90.5%和95.4%;NGAL、CysC敏感性明显高于BUN和Scr,差异有统计学意义(P<0.05)。结论血NGAL、CysC是早期诊断急性肾损伤较有价值的新型标记物,对损伤严重程度和预后的判断均有显著的预测价值。

【objective】To observe the application of blood neutrophils enzyme related lipid carrier protein gelatin(NGAL),serum levels of cysteine protease inhibitor C(CysC)detection in early diagnosis acute kidney injury.【Methods】Ninety-two patients with acute kidney injury(AKI)in the ICU of our hospital were selected,79 cases were assigned into the survival group,and the other 13 cases were assigned into the death group.Thirty patients without acute kidney injury in ICU during the same period were selected as the control group.All of them underwent blood NGAL,CysC detection at admission,and blood urea nitrogen(BUN)and serum creatinine(Scr)levels were analyzed.【Results】NGAL,CysC levels of the survival group and death group at ICU addmission were significantly higher than those of the control group(P<0.05).BUN and Scr levels of the death group at ICU admission were significantly higher than those of the control group and survival group(P<0.05).There were no statistically significant differences in BUN and Scr levels between the survival group and the control group(P>0.05).On the 3 rd day of admission NGAL,CysC,BUN and Scr levels of AKI patients continued to rise,which were significantly different from those of the control group(P<0.05).On the 7 th,14 th day of admission NGAL,CysC levels were on the decline,and on the 7 th day of admission BUN and Scr levels continued to rise,on the 14 th day they were on the decline.Cutoff value of NGAL was 46.29μg/L,the sensitivity and specificity were 85.2%and 95.4%respectively;cutoff value of CysC was 1.31μmol/L,the sensitivity and specificity were 90.5%and 95.4%respectively;the sensitivity of NGAL,CysC was significantly higher than that of BUN and Scr,and the difference was statistically significant(P<0.05).【Conclusion】Blood NGAL,CysC in early diagnosis of acute kidney injury are more valuable new markers with significant predictive value in injury severity and prognosis judgement.