血清NGAL和PCT对脓毒症相关急性肾损伤的评估及临床意义的研究

Evaluation and clinical significance of serum NGAL and PCT in sepsis-related acute kidney injury

目的:研究血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、降钙素原(PCT)对脓毒症相关急性肾损伤的评估价值及临床意义。方法:选择2015-09-2018-09期间我院收治的脓毒症患者进行回顾性分析,分为AKI组和非AKI组,检测血清NGAL、PCT、肌酐(Scr)、尿素氮(BUN)、IL-6、IL-10的含量,评估AKI患者肾功能恢复情况并分析影响因素。结果:AKI组患者的血清NGAL、PCT、Scr、BUN、IL-6水平均明显高于非AKI组,血清IL-10水平均明显低于非AKI组(P<0.05)且AKI分期越高,上述血清指标变化越显著;肾功能恢复患者的血清NGAL、PCT、IL-6水平明显高于肾功能未恢复患者,IL-10水平明显低于肾功能未恢复患者(P<0.05),Scr、BUN与肾功能未恢复患者比较差异无统计学意义(P>0.05);经logistic回归分析,血清NGAL、PCT、IL-6升高是肾功能未恢复的危险因素,IL-10升高是肾功能未恢复的保护因素。结论:血清NGAL、PCT对脓毒症相关急性肾损伤的严重程度具有评估价值、对肾功能恢复具有预测价值。

Objective:To study the value and clinical significance of serum neutrophil gelatinase-associated lipocalin(NGAL)and procalcitonin(PCT)in the assessment of sepsis-related acute renal injury.Method:Sepsis patients admitted to our hospital from September 2015 to September 2018 were retrospectively analyzed.They were divided into AKI group and non-AKI group.Serum NGAL,PCT,creatinine(Scr),blood urea nitrogen(BUN),IL-6 and IL-10 levels were measured.The renal function recovery of AKI patients was evaluated and the influencing factors were analyzed.Result:The serum levels of NGAL,PCT,Scr,BUN and IL-6 in AKI group were significantly higher than those in non-AKI group.The serum level of IL-10 in AKI group was significantly lower than that in non-AKI group(P<0.05).And the higher the AKI stage was,the more significant the changes of the above serum indexes were.The serum levels of NGAL,PCT and IL-6 of renal function recovery patients were significantly higher than those of renal function non-recovery patients(P<0.05).IL-10 level of renal function recovery patients was significantly lower than that of renal function non-recovery patients(P<0.05).NGAL and PCT levels of renal function recovery patients had no significant difference with those of renal function non-recovery patients(P>0.05).Logistics analysis showed that the increase of serum NGAL,PCT and IL-6 was the risk factors for the non-recovery of renal function,and the increase of IL-10 was the protective factor for the non-recovery of renal function.Conclusion:Serum NGAL and PCT are valuable in evaluating the severity of sepsis-related acute renal injury and predicting the recovery of renal function.