尿KIM-1IL-18NGAL及血清HGF在儿童脓毒症肾损害中的意义

【摘要】目的探讨尿肾损伤分子1（KIM-1）、IL-18、中性粒细胞明胶酶相关载脂蛋白（NGAL）及血清肝细胞生长因子（HGF）在儿童脓毒症肾损害中的意义。方法选择2013年1月至2015年1月治疗的脓毒症患）h80例，男女各40例。其中男性患儿与女性患儿中脓毒症、严重脓毒症各20例，将脓毒症患儿设为脓毒症无肾损伤组（非AKI组）；将严重脓毒症患儿设为脓毒症肾损伤组（AKI组）；选取40例同期儿童保健门诊正常体检的儿童为对照组。用酶联免疫吸附法检测患儿尿KIM-1、IL-18、NGALTLzfiz清HGF在入院时早期、急危重期、恢复期的水平。并探讨与患儿预后的关系。结果AKI组在早期、急危重期、恢复期尿KIM-1、IL-18、NGAL及血清HGF水平均逐渐升高，3个时期比较差异有统计学意义（p〈0．05）；与非AKI组及对照组比较，AKI组3个时期患儿尿KIM-1、IL-18、NGAL及血清HGF水平明显高于其他两组（P〈0．05）；而非AKI组与对照组比较，两组的尿KIM-1、IL-18、NGAL及血清HGF水平差异无统计学意义（P〉0．05）。入院时AKI组患儿的KIM-1、IL-18、NGAL及血清HGF分别为58．00ng／L、66．00ng／L、3．28μg／LTL821．36pg／ml，病死率34．21％，非AKI组及对照组病死率分别为10．00％、0．00％。结论尿KIM-1、IL-18、NGAL及血清HGF与儿童脓毒症肾损害有密切关系，其能反映脓毒症严重情况，与患儿病死率呈正相关。对尿KIM-1、IL-18、NGAL及血清HGF进行监测，可为临床早期诊断、治疗AKI及评估病情预后提供理论依据。

Objective To explore the urine KIM - 1, IL - 18, NGAL and serum levels of HGF in pediatric sepsis warning significance of renal damage. Methods Selected 80 cases of sepsis patients from January 2013 to January 2013 in our hospital as the research object, the men and women 40 cases in each. Children of men and women of sepsis, severe sepsis in children with all the 20 cases, 20 cases of male sepsis patients and 20 cases of sepsis female children set to sepsis without group kidney injury （ AKI ） ; 20 cases of male children with severe sepsis and 20 cases of severe sepsis women set to sepsis in children with renal injury group （ AKI ） ; Selected 40 cases of normal physical examination at the same time to our children care clinics for children in the control group. After venous sampling 2 ml and urine, children with enzyme linked immunosorbent method for detecting urine, IL - 18, KIM - 1 NGAL and serum levels of HGF in on admission, early, acute critical period, the recovery level, and explore the relationship with the prognosis of the patients. Results After tests, AKI group in the early days, the three periods of acute critical period, the recovery of urine, IL - 18, KIM - 1 NGAL serum HGF levels were increased, and three times more significant difference （ P〈0.05 ） ; Three periods respectively in the AKI group and the control group, compared to AKI group, IL - 18 children with urinary KIM - 1, NGAL and serum HGF level obviously is higher than the other two groups （ P〈 0.05 ） ; Instead of AKI group compared with control group, two groups of urine, IL - 18, KIM - 1 NGAL serum HGF levels and no significant difference （ P〉0.05 ） . On admission AKI group, IL - 18 children with KIM - 1, NGAL and serum levels of HGF were 58.00 ng/L, 66.00 ng/L, 66.00 mu g/L and 821.36 pg/mL, mortality was 34.21%, mortality of AKI group and the control group were 10.00%, 9.00% respectively. Conclusion The urine, IL - 18, KIM - 1 NGAL serum HGF and sepsis renal damage are closely connected with the children, these indicators can reflect sepsis severe situation, is positively correlated with child mortality. For urine KIM - 1, IL - 18, NGAL and to monitor the sermn HGF can AKI for clinical early diagnosis, treatment and provides the theory basis for evaluating the prognosis.