尿NGAL检测对横纹肌溶解致急性肾损伤患者的早期诊断价值

Early Diagnostic Value of Urinary NGAL in Patients with Acute Renal Injury Caused by Rhabdomyolysis

目的观察横纹肌溶解致急性肾损伤(acute kidney injury, AKI)患者的中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin, NGAL)水平,并分析其临床意义。方法选取 2017 年 3 月-2019年3月在赤峰市医院接受治疗的横纹肌溶解综合征患者为观察对象。根据其血清肌(serum creatinine,Scr)水平分为AKI组和无AKI组。观察两组患者尿NGAL、血胱抑素C(eys tatin C,CysC)、Scr、炎症因子水平的差异,并分析横纹肌溶解致急性肾损伤患者的NGAL水平与肾功能和炎症因子水平的相关性。结果AKI 组患者的尿 NGAL、血 CysC 水平分别为 55.92±3.08μg/L、1.31 ±0.26 mg/L,高于无 AKI 组的 6.48±1.04μg/L,0.67±0.13 mg/L(t 值=-117.943,-16.437,P<0.001);AKI 组患者的白介素-6(interleukin-6, IL-6)、超敏反应C 蛋白(hypersensitive response protein C, hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平分别为 22.28±3.15 mg/L、14.29±2.01 mg/L、28.73±2.25 ng/L,高于无 AKI 组的 7.76±1.0 4mg/L、5.63±1.12 mg/L、11.35 ± 2.04 ng/L(t=-34.001、-27.717、-39.191, P<0.001);AKI 组患者的 SCr、血尿素氮(bood urea nitrogen,BUN)水平分别为 142.85±10.28 μmol/L、11.09±1.07 mmol/L,高于无 AKI 组患者的 22.43±3.06μmol/L、4.38±0.75 mmol/L(t=-58.217,-36.602, P<0.001);横纹肌溶解致急性肾损伤患者的 NGAL 水平与 CysC、IL-6、hs-CRP、TNF-α、SCr、BUN水平呈正相关(P<0.05)。结论横纹肌溶解致急性肾损伤患者的尿NGAL水平较高,且与细胞因子和肾功能相关。

Objective To observe the level of Neutrophil gelatinase-associated lipocalin(NGAL) in patients with acute renal injury caused by rhabdomyolysis and to analyze its clinical significance. Methods The patients with rhabdomyolysis syndrome who were treated in Chifeng hospital from March 2017 to March 2019 were selected as the observation objects. According to their Scr level, they were divided into AKI group and non-AKI group. The levels of urinary NGAL, blood Cys tatin C (CysC), Serum creatinine (Scr) and inflammatory factors in the two groups were observed, and the correlation between the levels of NGAL and renal function and inflammatory factors in patients with acute renal injury caused by rhabdomyolysis were analyzed. Results The levels of urinary NGAL and blood CysC in AKI group were 55.92±3.08 pig/L, 1.31 ±0.26 mg/L respectively, higher than those in AKI group 6.48±1.04 jig/L, 0.67±0.13 mg/L(t=- 117.943,-16.437, P < 0.001). The levels of Interleukin-6(IL-6), Hypersensitive response protein C(hs-CRP) and Tumor necrosis factor-α(TNF-α) in AKI group were 22.28±3.15 mg/L, 14.29±2.01 mg/L, 28.73±2.25 ng/L, respectively, higher than those in AKI group 7.76±1.04 mg/L, 5.63±1.12 mg/L, 11.35±2.04 ng/L(t=-34.001,-27.717,-39.191, P < 0.001). The levels of SCR and BUN in AKI group were 142.85±10.28 jimol/L, 11.09±1.07 mmol/L respectively, higher than those in non-AKI group 22.43±3.06 jxmol/L, 4.38±0.75 mmol/L(t=-58.217,-36.602, P < 0.001). NGAL level was positively correlated with CysC, IL-6, hs-CRP, TNF-α, SCr and BUN levels in patients with acute renal injury induced by rhabdomyolysis (P < 0.05). Conclusion Urinary NGAL level in patients with acute renal injury caused by rhabdomyolysis is higher, and is related to cytokines and renal function.