血清中性粒细胞明胶酶相关载脂蛋白、核转录因子-κB及血清肌酐对重症急性胰腺炎伴急性肾损伤的预测价值

Value of serum neutrophil gelatinase-associated lipocalin,nuclear factor-κB and serum creatinine in predicting severe acute pancreatitis complicated with acute kidney injury

目的探究中性粒细胞明胶酶相关载脂蛋白(NGAL)、核转录因子-κB(NF-κB)及血清肌酐(Scr)对重症急性胰腺炎(SAP)患者伴急性肾损伤(AKI)的预测价值。方法本研究选择2019年1月至2021年1月我院重症医学科收治的122例SAP患者作为研究对象, 依据是否有AKI分为对照组(68例)和研究组(54例)。收集两组患者一般临床资料和实验室检查资料, 采集患者血清检测NGAL、NF-κB和Scr。采用Logistic回归模型分析SAP患者发生AKI的危险因素。采用受试者工作特征曲线(ROC)评估血清NGAL、NF-κB及Scr水平对SAP患者发生AKI的预测价值。结果研究组血清NGAL、NF-κB及Scr水平均高于对照组(P<0.05)。Logistic回归分析发现NGAL、NF-κB、Scr、BUN、hs-CRP、Cys C均为SAP患者发生AKI的独立危险因素(P<0.05)。ROC曲线显示血清NGAL、NF-κB、Scr水平单独和联合预测SAP患者AKI发生的AUC分别为0.788、0.762、0.753、0.894, 血清NGAL、NF-κB、Scr水平联合预测SAP患者发生AKI的AUC高于单独预测(P<0.05)。结论血清NGAL、NF-κB、Scr是SAP患者发生AKI的独立危险因素;血清NGAL、NF-κB、Scr水平对SAP患者发生AKI均具有预测价值, 三者联合预测时价值更高。

Objective To investigate the value of neutrophil gelatinase-associated lipocalin(NGAL),nuclear factor-κB(NF-κB)and serum creatinine(Scr)in predicting severe acute pancreatitis(SAP)complicated with acute kidney injury(AKI).Methods Included in this study were 122 SAP patients admitted to our Department of Critical Care Medicine between January 2019 and January 2021.The subjects were divided into the control group(n=68)and the study group(n=54)according to whether they had AKI.The two groups were retrieved for general clinical data and laboratory findings.Serum samples were collected from the patients and subjected to detection of NGAL,NF-κB and Scr.Logistic regression was used to analyze the risk factors for AKI in SAP patients.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum NGAL,NF-κB and Scr levels for AKI in SAP patients.Results The serum levels of NGAL,NF-κB and Scr in the study group were higher than those in the control group(P<0.05).Logistic regression analysis showed that NGAL,NF-κB,Scr,BUN,hs-CRP and Cys C were all independent risk factors for AKI in SAP patients(P<0.05).ROC curve showed that the AUC of serum NGAL,NF-κB and Scr levels,alone and in combination,to predict AKI in SAP patients were 0.788,0.762,0.753,and 0.894,respectively.The AUC of serum NGAL,NF-κB,and Scr levels used in combination was greater the any of these alone in predicting AKI in SAP patients(P<0.05).Conclusion Serum NGAL,NF-κB and Scr are independent risk factors for AKI in SAP patients.While any of serum NGAL,NF-κB and Scr levels is predictive for AKI in SAP patients,combination of the three tests can be more valuable in the prediction.