脓毒血症患儿血清和尿肾损伤指标水平及其相关性

The level and correlation of serum and urine renal damage indexes in children with sepsis

目的探讨脓毒血症患儿血清N-乙酰-β-D-葡萄糖苷酶(NAG)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿肾损伤分子-1(KIM-1)水平及其与病情的相关性。方法选取2018年1月至2019年5月广州市红十字会医院收治的脓毒血症患儿58例作为观察组,并进行序贯器官衰竭评分(SOFA评分),根据评分结果分为轻、中、重度三组。同期选择58例健康儿童作为对照组,分别检测两组血清NAG、NGAL含量及尿KIM-1含量,再比较观察组轻、中、重度三组间的各项指标的差异性。Pearson相关分析探讨血清NAG、NGAL水平和尿KIM-1水平分别与SOFA评分的相关性。结果观察组血清NAG、NGAL和尿KIM-1明显高于对照组[(30.53±7.18)U/L比(12.36±3.46)U/L、(78.72±12.97)μg/L比(30.62±3.24)μg/L、(60.59±10.73)ng/L比(22.54±4.25)ng/L](P<0.05);中度组、重度组血清NAG、NGAL和尿KIM-1水平均高于轻度组[(31.81±1.41)和(34.24±1.70)U/L比(28.11±2.36)U/L、(85.94±5.45)和(94.17±3.91)μg/L比(67.45±7.58)μg/L、(67.03±4.63)和(72.17±3.98)ng/L比(51.49±7.08)ng/L],重度组血清NAG、NGAL和尿KIM-1水平均高于中度组(P<0.05);Pearson相关分析显示,脓毒血症患儿血清NAG、NGAL水平和尿KIM-1水平均与SOFA评分呈正相关(r=0.836、0.935、0.892,均P<0.01)。结论脓毒血症患儿血清NAG、NGAL和尿KIM-1水平显著上升,并且与患儿病情严重程度相关,可以对病情的诊断提供一定的帮助。

Objective To investigate the levels of serum N-acetyl-β-D-glucosidase(NAG),neutrophil gelatin-related lipid transporter protein(NGAL)and urinary kidney injury molecule-1(KIM-1)in children with sepsis and their correlation with the condition.Methods Fifty-eight children with sepsis were selected as the observation group from January 2018 to May 2019 in Guangzhou Red Cross Hospital,and sequential organ failure assessment(SOFA)score was conducted.According to the score results,all the patients were divided into three groups:mild,moderate and severe group.Meanwhile,58 healthy children were selected as the control group,and the serum NAG,NGAL levels and urinary KIM-1 level in the two groups were detected respectively,and the differences in various indicators among the mild,moderate and severe groups were compared.Pearson correlation analysis was used to explore the correlation between serum NAG,NGAL levels and urinary KIM-1 level and SOFA scores respectively.Results The levels of serum NAG,NGAL and urinary KIM-1 in the observation group were all significantly higher than the control group:(30.53±7.18)U/L vs.(12.36±3.46)U/L,(78.72±12.97)μg/L vs.(30.62±3.24)μg/L,(60.59±10.73)ng/L vs.(22.54±4.25)ng/L,and there were statistical differences(P<0.05).Serum NAG,NGAL levels and urinary KIM-1 level in the moderate group and the severe group were all higher than the mild group:(31.81±1.41)and(34.24±1.70)U/L vs.(28.11±2.36)U/L,(85.94±5.45)and(94.17±3.91)μg/L vs.(67.45±7.58)μg/L,(67.03±4.63)and(72.17±3.98)ng/L vs.(51.49±7.08)ng/L,while the levels of serum NAG,NGAL and urinary KIM-1 in the severe group were all higher than those in the moderate group(P<0.05).Pearson correlation analysis showed that the levels of serum NAG,NGAL and urinary KIM-1 levels in sepsis children were positively correlated with SOFA score(r=0.836,0.935,0.892;P<0.01).Conclusions The levels of serum NAG,NGAL and urinary KIM-1 in children with sepsis increased significantly,and were related to the severity of the disease,which provides some reference value for the judgment of the sepsis condition.