中性粒细胞明胶酶相关载脂蛋白和肾损伤分子-1水平与创伤性脑损伤患者发生急性肾损伤的相关性研究

Correlation between NGAL and KIM-1 Levels and Acute Renal Injury in Patients with Traumatic Brain Injury

目的检测创伤性脑损伤(TBI)并发急性肾损伤(AKI)患者血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、肾损伤分子-1(KIM-1)表达水平,探讨NGAL和KIM-1与TBI合并AKI的相关性。方法选取2020年10月至2022年6月在江阴市中医院进行救治的95例TBI患者,根据是否发生AKI分为AKI组44例,无AKI组51例。比较分析两组患者的临床资料和实验室检测指标。应用酶联免疫吸附法检测两组患者血清NGAL、KIM-1水平,采用Pearson相关性分析血清NGAL、KIM-1水平与肾损伤指标[尿素氮(BUN)、肌酐(Scr)]的相关性,采用多因素Logistic回归分析TBI并发AKI的影响因素,以ROC曲线分析各因素对TBI患者发生AKI的诊断价值。结果AKI组患者血清NGAL、KIM-1水平明显高于无AKI组(均P<0.05),AKI组患者Scr、BUN、C反应蛋白(CRP)和IL-6水平均明显高于无AKI组,差异均有统计学意义(均P<0.05),血清NGAL水平与Scr、BUN水平均呈正相关(均P<0.05),血清KIM-1水平与Scr、BUN水平均呈正相关(均P<0.05),Scr、BUN、CRP、NGAL和KIM-1水平为TBI患者并发AKI的影响因素(均P<0.05)。ROC曲线结果显示血清Scr、BUN、CRP、NGAL和KIM-1联合诊断TBI患者发生AKI的效能均优于各指标单独诊断(P<0.05),敏感度为93.2%。结论TBI并发AKI患者血清NGAL、KIM-1水平上调,且两者水平变化与TBI患者并发AKI相关。

Aim To detect the expression levels of neutrophil gelatinase associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)in patients with traumatic brain injury(TBI)complicated with acute kidney injury(AKI),and to explore their correlation with AKI in TBI.Methods A total of 95 patients with TBI who were treated in our hospital from October 2020 to June 2022 were selected and divided into a AKI group(44 cases)and a non AKI group(51 cases)according to whether AKI occurred,the basic clinical data of all the patients was collected and sorted out.The levels of serum NGAL and KIM-1 of patients were detected by enzyme-linked immunosorbent assay and compared,the clinical data and laboratory routine test indexes of the two groups were compared and analyzed.Pearson correlation analysis was applied to analyze the correlation between serum NGAL,KIM-1 levels and renal injury indicators[urea nitrogen(BUN),creatinine(Scr)],multivariate Logistic regression was applied to analyze the influencing factors of TBI complicated with AKI,the ROC curve was used to analyze the diagnostic value of each factor on the occurrence of AKI in patients with TBI.Results The levels of serum NGAL and KIM-1 in AKI group were obviously higher than those in non AKI group(P<0.05),Scr,BUN,CRP and IL-6 in AKI group were obviously higher than those in non AKI group(P<0.05).Serum NGAL level was positively correlated with Scr and BUN levels(P<0.05).Serum KIM-1 level was positively correlated with Scr and BUN levels(P<0.05).Scr,BUN,CRP,NGAL and KIM-1 were the influencing factors of TBI patients with AKI(P<0.05).The results of the ROC curve showed that the efficacy of the combination of serum Scr,BUN,CRP,NGAL and KIM-1 in diagnosing AKI in patients with TBI was better than that of each index alone(P<0.05),with a sensitivity of 93.2%.Conclusion The levels of serum NGAL and KIM-1 in TBI patients with AKI are up-regulated,and their changes are related to AKI in TBI patients.