外周血胱抑素C、肾损伤因子-1、中性粒细胞明胶酶相关脂质运载蛋白在慢性乙型肝炎早期肾损伤患者中的诊断价值

Diagnostic value of peripheral blood cystatin C,kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in patients with chronic hepatitis B and early renal injury

目的探究外周血胱抑素C(Cys-C)、肾损伤因子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在慢性乙型肝炎合并早期肾损伤患者中的诊断价值。方法选取2018年4月至2021年4月于大连市公共卫生临床中心收治的56例慢性乙型肝炎合并早期肾损伤患者作为观察组,并按性别、年龄匹配同期收治的56例未出现肾损伤的慢性乙型肝炎患者作为对照组。比较两组患者的肾小球滤过率(eGFR)、Cys-C、KIM-1、NGAL水平,分析Cys-C、KIM-1、NGAL水平对慢性乙型肝炎合并早期肾损伤患者的检测价值及与eGFR的相关性。结果观察组患者的eGFR低于对照组,Cys-C、KIM-1、NGAL水平高于对照组,差异有统计学意义(P<0.05)。ROC结果显示:血清Cys-C、KIM-1、NGAL水平对慢性乙型肝炎合并早期肾损伤患者诊断价值AUC分别为0.771、0.785、0.766,低于联合检测的0.896(P<0.05)。血清Cys-C、KIM-1、NGAL的cut-off值分别为1.24 mg/L、1.03 mg/L、116.82 ng/ml。Cys-C、KIM-1、NGAL水平与eGFR均呈负相关(P<0.05)。结论血清Cys-C、KIM-1、NGAL水平及三者联合检测均对慢性乙型肝炎合并早期肾损伤患者具有诊断价值,值得临床参考。

Objective To explore diagnostic value of peripheral blood cystatin C(Cys-C),kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)in patients with chronic hepatitis B and early renal injury.Methods A total of 56 patients with chronic hepatitis B and early renal injury admitted to Dalian Public Health Clinical Center from April 2018 to April 2021were enrolled as the observation group,while other 56 patients with matched gender and age,and simple chronic hepatitis B during the same period were enrolled as the control group.The levels of estimated glomerular filtration rate(eGFR),Cys-C,KIM-1 and NGAL between the two groups were compared.The detection value of Cys-C,KIM-1 and NGAL levels in patients with chronic hepatitis B and early renal injury and their correlation with eGFR were analyzed.Results The eGFR in the observation group was lower than that in the control group,and the levels of Cys-C,KIM-1 and NGAL in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).The results of ROC showed that the AUC of serum Cys-C,KIM-1 and NGAL levels in patients with chronic hepatitis B and early renal injury was 0.771,0.785 and 0.766 respectively,lower than that of combined detection(0.896,P<0.05).The cut-off values of Cys-C,KIM-1 and NGAL were 1.24 mg/L,1.03 mg/L,116.82 ng/ml.Cys-C,KIM-1,NGAL levels were negatively correlated with eGFR(P<0.05).Conclusion The levels of serum Cys-C,KIM-1,NGAL and their combined detection have diagnostic value for patients with chronic hepatitis B and early renal injury,which is worthy of clinical reference.