急性创伤性肾损伤患者尿中性粒细胞明胶酶脂质运载蛋白、肾损伤分子1和白细胞介素18水平及诊断意义

Levels and Diagnostic Significances of Urinary NGAL,KIM-1 and IL-18 in Patients with Acute Traumatic Renal Injury

目的探讨急性创伤性肾损伤患者尿中性粒细胞明胶酶脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1)、白细胞介素18(IL-18)水平及诊断意义。方法选取符合纳入及排除标准急性创伤性肾损伤50例作为创伤组,另选取健康体检者50例作为对照组。观察比较创伤组入院时及对照组健康体检时尿NGAL、KIM-1、IL-18及血清肌酐(SCr)水平,以及急性创伤性肾损伤患者入院后不同时间点尿NGAL、KIM-1、IL-18及SCr水平,并将急性创伤性肾损伤患者尿NGAL、KIM-1、IL-18水平与SCr水平行相关性分析,同时绘制受试者工作特征(ROC)曲线评价尿NGAL、KIM-1、IL-18和SCr水平对急性创伤性肾损伤的诊断意义。结果创伤组入院时尿NGAL、KIM-1、IL-18和SCr水平均明显高于对照组健康体检时,差异有统计学意义(P<0.05)。急性创伤性肾损伤患者随着入院时间延长尿NGAL、KIM-1、IL-18和SCr水平均逐渐增高,不同时间点间同一指标比较差异均具有统计学意义(P<0.05)。急性创伤性肾损伤患者尿NGAL、KIM-1、IL-18水平与SCr水平均呈正相关。入院后8 h尿NGAL及入院后24 h尿NGAL、KIM-1、IL-18和SCr水平对急性创伤性肾损伤患者均具有诊断价值。结论急性创伤性肾损伤患者尿NGAL、IL-18、KIM-1水平在SCr水平上升之前会显著升高,且尿NGAL、IL-18、KIM-1均对急性创伤性肾损伤有预测价值,故尿NGAL、IL-18、KIM-1可作为急性创伤性肾损伤患者早期诊断的生物学标志物。

Objective To investigate expression levels and diagnosed significances of urinary neutrophil gelatinase lipocalin （ NGAL） ,renal injury molecule-1 （ KIM-1）and interleukin18 （ IL-18）in patients with acute traumatic renal injury.Methods A total of 50 patients with acute traumatic kidney injury,who had met inclusion and exclusion standard,were selected as trauma group,and other 50 healthy people taking medical examination were selected as control group. Levels of urinary NGAL,KIM-1,IL18 and serum creatinine （ SCr）at the time of admission in trauma group and taking medical examination in control group,and urinary NGAL,KIM-1,IL-18 and SCr levels at different times in trauma group were observed andcompared. The relations between urinary NGAL,KIM-1 and IL-18 with SCr in trauma group were analyzed,and receiver operating curve （ ROC）was simultaneously drawn to evaluate significances of NGAL,KIM-1,IL-18 and SCr levels in diagnosisof acute traumatic kidney injury. Results In trauma group,urinary NGAL,KIM-1,IL-18 and SCr levels at the time of admission were significantly higher than those at the time of taking medical examination in control group （ P 〈 0.05） . In patientswith acute traumatic renal injury,urinary NGAL,KIM-1,IL-18 and SCr levels were gradually increased with prolonged hospital stay,and the differences in same indicator at different times were statistically significant （ P 〈 0.05 ） . Urinary NGAL,KIM-1 and IL-18 levels were positively related to SCr level in patients with acute traumatic renal injury. Urinary NGAL levelon the 8thh after admission and NGAL,KIM-1,IL-18 and SCr levels on the 24thh after admission had significances in diagnosis of patients with acute traumatic renal injury. Conclusion Urinary NGAL,IL-18 and KIM-1 levels in patients with acutetraumatic renal injury can be found significantly increased before SCr level will be increased,and urinary NGAL,IL-18 andKIM-1 levels have diagnosed significances,and therefore urinary NGAL,IL-18 and KIM-1 can be used as biomarkers in earlydiagnosis of patients with acute traumatic renal injury.