血清脂质运载蛋白-2与炎症反应的关系及其对急性胰腺炎合并急性肾损伤的预测价值

Correlation of plasma lipocalin-2 with inflammation and predictive value of lipocalin-2 for detecting acute kidney injury in acute pancreatitis

目的探讨急性胰腺炎(acute pancreatitis,AP)患者血清脂质运载蛋白-2(lipocalin-2,LCN2)与炎症反应水平的关系及其对急性肾损伤(acute kidney injury,AKI)的预测价值。方法前瞻性收集2016年6月—2018年6月巴中市中医院住院的AP患者91例,比较AKI组(n=29)和非AKI组(n=62)的各项临床参数。分析血清LCN2与AP患者炎症反应标志物水平的相关关系。采用受试者工作特征曲线探讨血清LCN2浓度预测AP并发AKI的价值。结果与非AKI组比较,AKI组血清C反应蛋白[(64.8±10.5)vs.(148.3±21.6)mg/L]、降钙素原[(3.5±2.3)vs.(4.8±3.9)μg/L]、尿素氮[(5.5±2.1)vs.(6.6±2.8)mmol/L]、肌酐[(80.3±28.1)vs.(107.3±30.8)μmol/L]、白细胞介素-6[(10.1±3.7)vs.(16.2±4.6)pg/mL]和LCN2[(155.0±37.6)vs.(394.8±53.1)mg/mL]明显增高,血钙水平[(2.6±1.3)vs.(2.0±1.0)mmol/L]明显降低,差异均有统计学意义(P<0.05)。血清LCN2浓度与C反应蛋白、白细胞介素-6及降钙素原的水平呈正相关(r=0.694、0.762、0.555,P<0.05)。血清LCN2诊断AP合并AKI的受试者工作特征曲线下面积为0.844(P<0.05);以210.2 ng/mL为截断值,血清LCN2诊断AKI的灵敏度和特异度分别为81.3%和81.4%。结论 AP合并AKI患者血清LCN2水平明显增高。血清LCN2水平与炎症反应水平呈正相关,是预测AKI的可靠指标。

Objective To explore the correlation of serum lipocalin-2(LCN2)with inflammation and the predictive value of LCN2 for detecting acute kidney injury(AKI)in acute pancreatitis(AP).Methods Nighty-one patients with AP,who were admitted to Bazhong Municipal Hospital of Traditional Chinese Medicine between June 2016 and June 2018,were enrolled in the present study.Clinical paramaters were analyzed between patients with AKI(n=29)and patients without AKI(n=62).The correlation of serum LCN2 with inflammation was assessed with Pearson’s correlation analysis.The area under the receiver operating characteristic curve(ROC AUC)for serum LCN2 predicting AKI in AP patients was assessed.Results Compared with the patients without AKI,the patients with AKI showed increased serum levels of C-reactive protein[(64.8±10.5)vs.(148.3±21.6)mg/L],procalcitonin[(3.5±2.3)vs.(4.8±3.9)μg/L],urea nitrogen[(5.5±2.1)vs.(6.6±2.8)mmol/L],creatinine[(80.3±28.1)vs.(107.3±30.8)μmol/L],interleukin-6[(10.1±3.7)vs.(16.2±4.6)pg/mL],and LCN2[(155.0±37.6)vs.(394.8±53.1)mg/mL],as well as decreased level of calcium[(2.6±1.3)vs.(2.0±1.0)mmol/L],the differences were all statistically significant(P<0.05).The serum level of LCN2 was correlated with C-reactive protein(r=0.694,P<0.05),interleukin-6(r=0.762,P<0.05),and procalcitonin(r=0.555,P<0.05)in patients with AP.The ROC AUC of LCN2 for predicting AKI was 0.844(P<0.05),with a sensitivity of 81.3%and a specificity of 81.4%when the cut-off value was 210.2 ng/mL.Conclusions Serum LCN2 concentration is elevated in patients with AKI.In patients with AP,serum LCN2 level is positively correlated with C-reactive protein,interleukin-6,and procalcitonin.It can be regarded as a reliable indicator for predicting AKI.