摘要
目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)检测在急性肾功能损伤(AKI)早期诊断中的意义。方法收集无慢性肾病的重症监护病房(ICU)、冠心病监护病房(CCU)患者60例,分别在其术前及术后6、12、48 h采集血样,其中27例发生AKI(AKI组),以其余33例未发生AKI(无AKI组)。应用酶联免疫吸附试验(ELISA)检测血清NGAL浓度,碱性苦味酸法检测血清肌酐(SCr)浓度,胶乳增强免疫浊度法检测血清半胱氨酸蛋白酶抑制剂C(Cys C)浓度。以48 h内SCr高于基础水平50%作为AKI的诊断标准,应用受试者工作特征(ROC)曲线评估NGAL在AKI早期诊断中的效力。结果与术前比较,AKI组术后6、12、48 h的血清NGAL明显升高,Cys C在术后12、48 h明显升高,而SCr在术后48 h才显著升高。无AKI组术前与术后6、12、48 h的NGAL、SCr、Cys C浓度差异无统计学意义(P>0.05)。术后6、12、48 h血清NGAL的ROC曲线下面积为0.51[95%可信区间(CI):0.25~0.78]、0.80(95%CI:0.58~0.95)、0.85(95%CI:0.61~0.99)。结论血清NGAL在术后6 h上升,术后12 h即能较好地预测AKI,其预测AKI时间早于Cys C和SCr。血清NGAL可能在AKI早期诊断中有良好的应用价值。
Objective To investigate the clinical significance of serum neutrophil gelatinase-associated lipocalin(NGAL) detection in early diagnosis of acute kidney injury(AKI).Methods A total of 60 inpatients in intensive care unit(ICU) and coronary care unit(CCU) without chronic kidney diseases were enrolled.Sera were collected before surgery and 6,12 and 48 h after surgery respectively.There were 27 AKI patients and other 33 patients without AKI.The concentration of NGAL was determined by enzyme-linked immunosorbent assay(ELISA).Serum creatinine(SCr) was detected by Jaffé reaction method.Serum cystatin C(Cys C) was detected by Latex-enhanced immunoturbidimetry.AKI was defined as an increase in SCr of at least 50% from baseline within 48 h.The efficiency of NGAL in early diagnosis of AKI was evaluated by receiver operating characteristic(ROC) curve.Results Serum NGAL increased significantly 6,12 and 48 h after surgery,while serum Cys C increased 12 and 48 h after surgery,and SCr increased 48 h after surgery in the AKI group.There was no obvious difference in the concentrations of NGAL,SCr and Cys C in the non-AKI group before and 6,12 and 48 h after surgery(P0.05).By ROC curve analysis,serum NGAL 6 h after surgery had an area under the curve of 0.51 [95% confidence interval(CI): 0.25-0.78],serum NGAL 12 h after surgery had an area under the curve of 0.80(95%CI: 0.58-0.95),and serum NGAL 48 h after surgery had an area under the curve of 0.85(95%CI: 0.61-0.99).Conclusions Serum NGAL increases 6 h after surgery and predicts AKI accurately 12 h after surgery.For predicting AKI,serum NGAL is earlier than Cys C and SCr,and shows that serum NGAL can be as potential marker for the early diagnosis of AKI.
出处
《检验医学》
CAS
2012年第4期287-290,共4页
Laboratory Medicine
基金
上海市宝山区科委课题资助项目(08-E-23)