骨折创伤性休克患者血清KIM-1、NGAL、NAG水平变化及其对病情诊断预测价值

Changes of Serum KIM-1,NGAL and NAG Levels in Patients with Fracture Traumatic Shock and Diagnostic and Predictive Values for the Disease

目的评估血清肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及N-乙酰-β-D-葡萄糖苷酶(NAG)对骨折创伤性休克患者病情的预测价值。方法选取武警宁夏总队医院2018年9月至2022年7月收治的88例骨折创伤性休克患者为观察组,另选取同样数量的健康体检者为对照组。根据急性生理学和慢性健康状况量表(APACHE-Ⅱ)将观察组分为轻中度组49例,重度组39例。采用ELISA法检测观察组与对照组患者血清KIM-1、NGAL、NAG水平的差异,以及观察组中不同严重程度骨折创伤性休克患者血清KIM-1、NGAL、NAG水平差异;采用Pearson相关分析分析KIM-1、NGAL、NAG与患者病情严重程度的相关性;采用受试者工作特征(ROC)曲线评估上述指标单一及联合对患者病情的预测价值。结果Elisa结果显示,观察组血清KIM-1、NGAL、NAG水平明显高于对照组,且重度组明显高于轻中度组。Pearson分析结果显示,血清KIM-1(r=0.411,P<0.001)、NGAL(r=0.421,P<0.001)、NAG(r=0.381,P<0.001)水平与骨折创伤性休克患者病情严重程度相关。血清KIM-1、NGAL、NAG及三者联合诊断预测骨折创伤性休克的AUC分别为0.755、0.750、0.772及0.915。结论血清KIM-1、NGAL和NAG具有作为辅助预测骨折创伤性休克患者病情严重程度指标的潜力,且三者联合检测更具有效力,监测以上指标有利于骨折创伤性休克患者的及时诊疗。

Objective To evaluate the predictive values of serum kidney injury molecule-1(KIM-1),neutrophil gelatinase-associated lipid transporter(NGAL)and N-acetyl-β-D-glucosidase(NAG)in patients with traumatic fracture shock.Methods A total of 88 patients with traumatic shock from fractures admitted to Ningxia Armed Police Corps Hospital from September 2018 to July 2022 were selected as the observation group,and the same number of healthy subjects were selected as the control group.According to the Acute Physiology and Chronic Health Evaluation(APACHE-Ⅱ),the observation group was divided into the mild and moderate group(49 cases)and the severe group(39 cases).The serum levels of KIM-1,NGAL and NAG were detected by ELISA between the observation group and the control group,and between the mild and moderate group and the severe group.Pearson correlation was used to analyze the correlation between the three indicators above and the disease severity of patients.Receiver operating characteristic(ROC)curve was used to evaluat the predictive values of single and combination of the above indicators.Results ELISA results showed that the expressions of KIM-1,NGAL and NAG in the observation group were significantly higher than those in the control group,and those in the severe group were significantly higher than those in the mild and moderate group.The results of Pearson analysis showed that serum levels of KIM-1(r=0.411,P<0.001),NGAL(r=0.421,P<0.001)and NAG(r=0.381,P<0.001)were significantly correlated with the condition of patients with fracture traumatic shock.The AUC of serum KIM-1 in the diagnosis of fracture traumatic shock was 0.755,the AUC of NGAL was 0.750,the AUC of NAG was 0.772,and the AUC of the combination of the three was 0.915.Conclusion Serum KIM-1,NGAL and NAG have the potential to be used as indicators to predict the condition of patients with fracture traumatic shock,and the combined detection of the three is more conducive to the diagnosis.