NGAL对AP合并AKI的诊断价值

Diagnostic value of urinous NGAL in detecting AKI in AP

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对急性胰腺炎(AP)合并急性肾损伤(AKI)的诊断价值。方法选择2014年6月至2016年6月巴中市中心医院院收治的AP患者102例,比较AKI组和非AKI组的临床病理学参数。采用ROC曲线评价尿NGAL对AP患者并发AKI的诊断价值。结果与非AKI组比较,AKI组住院天数明显延长,急性重症胰腺炎(SAP)的比例增高,C-反应蛋白(CRP)、uNGAL均明显增高,血清白蛋白(ALB)明显降低,差异均有统计学意义(P<0.05)。SAP、CRP≥102 mg/L及尿NGAL≥1.5μg/L是AP并发AKI的独立危险因素。尿NGAL≥1.8μg/L诊断AP并发AKI的敏感性和特异性分别为90.7%和92.0%,阳性预测值为85.1%,阴性预测值为90.6%。结论 AP患者合并AKI时,尿NGAL明显增高,尿NGAL水平是一种预测AP并发AKI的无创的可靠指标。

Objective To explore the diagnostic value of urinous neutrophil gelatinase-associated lipocalin（NGAL）in acute pancreatitis（AP）complicated with acute kidney injury（AKI）. Methods 102 patients with AP were enrolled in our study from Jun. 2014 to Jun. 2016. Clinicopathological paramaters of patients complicated with or without AKI were assessed. The area under the receiver operating characteristic curve（ROC）for urinous NGAL detecting AKI was examined.Results Compared with the non AKI group,the days of hospitalization were significantly prolonged in AKI group,more patients with severe acute pancreatitis（SAP）,higher level of C-reactive protein（CRP）,uNGAL,and lower level of serum albumin（ALB）（P〈0.05）. SAP,CRP≥ 102 mg/L and urinous NGAL≥ 1.5 μg/L were independent risk factors for AKI in patients with AP. According to ROC analysis, the sensitivity, specificity, positive predictive value and negative predictive value of urinous NGAL were 90.7%,92.0%,85.1% and 90.6%,respectively for the cut-off value of 1.8 μg/L.Conclusion Urinous NGAL concentration is elevated in AP patients complicated with AKI,and is a credible paramater to noninvasively detection of AKI of patients with AP.