尿钙卫蛋白在成人急性肾损伤患者中的应用价值

The application value of urinary calprotectin in adult patients with acute kidney injury

目的观察成人急性肾损伤患者和健康人群中尿钙卫蛋白(Calprotectin)浓度水平,探究尿Calprotectin在成人急性肾损伤中的应用价值。方法选择急性肾损伤(acute kidney injury,AKI)患者(AKI组)50例和健康人群(健康对照组)30例,检测尿Calprotectin、血清肌酐、血尿素氮、尿肾损伤分子1(kidney injury molecule 1,KIM-1)、血白蛋白和血红蛋白等指标,同时收集一般资料,比较2组上述检测指标的差异。采用ROC曲线分析尿Calprotectin对成人AKI的预测价值。结果AKI组尿Calprotectin、尿KIM-1、血肌酐、血尿素氮均高于健康对照组(t=10.113、9.152、11.119、9.049,均P<0.001)。AKI组尿Calprotectin与血肌酐、血尿素氮、尿KIM-1呈正相关(r=0.794、0.462、0.409,P值分别为<0.001、0.001、0.003)。AKI组尿Calprotectin与血白蛋白、血红蛋白呈负相关(r=-0.620、-0.289,P值分别为0.042、<0.001)。ROC曲线发现尿Calprotectin对成人AKI的诊断界值在55.17ng/ml时,AUC为0.747(95%CI:0.641~0.853),敏感度和特异度分别为62.0%和90.0%。结论尿Calprotectin浓度在成人AKI患者中明显升高,且AKI患者尿Calprotectin和血肌酐、尿素氮、尿KIM-1呈正相关,其诊断成人AKI的灵敏度和特异度均较高,提示尿Calprotectin在预测成人AKI和反映AKI患者治疗效果和恢复进程中具有重要临床价值。

Objective To explore the application value of urinary calprotectin in adult acute kidney injury(AKI)by observing urinary calprotectin concentration in adult AKI patients and healthy people.Methods Fifty patients with AKI(AKI group)and 30 healthy people(healthy control group)were selected to determine the indexes of urinary calprotectin,serum creatinine,blood urea nitrogen,urinary kidney injury molecule-1(KIM-1),blood albumin and hemoglobin.General clinical data and laboratory indexes were compared between the two groups.ROC curve was used to analyze the predictive value of urinary calprotectin for adult AKI.Results Urinary calprotectin,urinary KIM-1,serum creatinine and blood urea nitrogen were higher in AKI group than in healthy control group(t=10.113,9.152,11.119 and 9.049 respectively;P<0.001).Urinary calprotectin was positively correlated with serum creatinine(r=0.794,P<0.001),urea nitrogen(r=0.462,P=0.001)and urinary KIM-1(r=0.409,P=0.003),and was negatively correlated with serum albumin(r=-0.620,P=0.042)and hemoglobin(r=-0.289,P<0.001)in AKI group.When the diagnostic limit of urinary calprotectin for adult AKI was set at 55.17ng/ml,the area under the ROC curve was 0.747(95%CI:0.641~0.853),with the sensitivity of 62.0%and specificity of 90.0%.Conclusion Urinary calprotectin concentration was significantly increased,and was positively correlated with serum creatinine,blood urea nitrogen and urinary KIM-1 levels in adult AKI patients.The sensitivity and specificity of urinary calprotectin for the diagnosis of adult AKI are higher.Therefore,urinary calprotectin has an important clinical value in the prediction and evaluation of therapeutic effect and recovery process in adult AKI patients.