重症感染合并急性肾损伤中NGAL的变化

Diagnostic value of neutrophil gelatinase-associated lipocalin in severe infection with acute kidney injury

目的探讨尿中性粒细胞明胶酶相关载脂蛋白在重症感染合并急性。肾损伤中的诊断价值。方法选择2010年1月--2011年6月在新疆自治区人民医院ICU住院的重症感染患者79例，按急性肾损伤的诊断标准分为急性肾损伤组和非急性肾损伤组。分别测定尿中性粒细胞明胶酶相关载脂蛋白、N-乙酰-β-D-氨基葡萄糖苷酶、微量白蛋白和血肌酐的浓度。通过受试者工作特征曲线及曲线下面积评价各项指标的敏感性。结果急性肾损伤组中各项指标的测定浓度明显高于非急性肾损伤组，其中尿中性粒细胞明胶酶相关载脂蛋白的敏感性和特异性分别为0．95和0．90，曲线下面积=0．986（0．9681．004）；血肌酐的敏感性和特异性分别为0．75和0．69，曲线下面积=0．776（0．705～0．852），差异具有统计学意义（P〈0．001）。结论’尿中性粒细胞明胶酶相关载脂蛋白的敏感性高于血肌酐，可以作为重症感染合并急性肾损伤的早期诊断标记物。

Objective To explore the clinical value of urine neutrophil gelatinase-associated lipocalin（NGAL） in the diagnosis of severe infection with acute kidney injury（AKI）. Methods Seventynine cases of severe infection in ICU from January 2010 to June 2011 were selected, and divided into AKI group and non AKI group according to the AKI diagnosis standard. The urine NGAL, NAG, mALB and SCr concentrations were determined. Through the ROC and AUC the sensitivity of the indexes was evaluated. Results In AKI group,the concentrations of all indexes were higher than in non- AKI group. The sensitivity and specificity of urine NGAL and SCr were 0.95 and 0.90, AUC ＋ 0. 986 （0. 968〈1. 004）;0. 75 and 0. 69, AUC = 0. 776（0. 705-0. 852） respectively（P〈0. 001）. Conclusions The sensitivity of the urine NGAL is higher than that of SCr,and the urine NGAL can be used as an enrlv diagnosis marker for severe infection with AKI.