人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值

郑静; 何海兰; 张国英

doi:10.16016/j.1000-5404.201608135

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人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值

临床医学 | 更新时间：2020-08-05

- 人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值
- Neutrophil gelatinase-associated lipocalin as diagnosis biomarker for acute renal injury in pediatric patients with sepsis in intensive care unit
- 第三军医大学学报 2017年39卷第2期页码：196-200
- 作者机构：
  
  1.610014 成都,成都市妇女儿童中心医院儿童重症医学科
  2.610072 成都,四川省人民医院儿科
- 作者简介：
  
  张国英, E-mail: Zhangguoying412@126.com Zhang Guoying, E-mail: Zhangguoying412@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201608135
  中图分类号： R446.1;R726.31;R726.92
- 纸质出版日期：2017-1-30，
  
  收稿日期：2016-8-24，
  
  录用日期：2016-9-25
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郑静, 何海兰, 张国英. 人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值[J]. 第三军医大学学报, 2017,39(2):196-200.

Jing Zheng, Hailan He, Guoying Zhang. Neutrophil gelatinase-associated lipocalin as diagnosis biomarker for acute renal injury in pediatric patients with sepsis in intensive care unit[J]. J Third Mil Med Univ, 2017,39(2):196-200.
郑静, 何海兰, 张国英. 人中性粒细胞明胶酶相关性脂质运载蛋白对ICU儿童脓毒症致急性肾损伤的预测诊断价值[J]. 第三军医大学学报, 2017,39(2):196-200. DOI： 10.16016/j.1000-5404.201608135.

Jing Zheng, Hailan He, Guoying Zhang. Neutrophil gelatinase-associated lipocalin as diagnosis biomarker for acute renal injury in pediatric patients with sepsis in intensive care unit[J]. J Third Mil Med Univ, 2017,39(2):196-200. DOI： 10.16016/j.1000-5404.201608135.

摘要

目的

观察重症监护室(intensive care unit，ICU)中脓毒症患儿诊断急性肾损伤(acute kidney injury，AKI)前血浆及尿中人中性粒细胞明胶酶相关性脂质运载蛋白(neutrophil gelatinase associated lipocalin

NGAL)水平变化，并探讨其对脓毒症AKI预测诊断价值。

方法

纳入成都妇女儿童中心医院2013年7月至2016年7月ICU收治的150例肾功能正常脓毒症患儿。分别于患儿进入ICU时(D1)至第6天(D6)上午9时左右取患儿新鲜尿液及静脉血检测血浆及尿液中NGAL水平；入ICU时(D1)至第7天(D7)上午9时检测血清肌酐(serum creatinine，SCr)水平。根据全球改善肾脏病预后组织(KDIGO)2012年标准将脓毒症患儿分为AKI组和非AKI组；采用ROC曲线下面积(area under curve，AUC)分析患儿AKI诊断前72、48、24 h血浆及尿NGAL对AKI的预测诊断价值。

结果

150例脓毒症患儿中，ICU 7 d内52例患儿诊断AKI，其发生率为34.6%；患儿AKI诊断前48、24 h尿和血浆中NGAL水平较诊断前72 h明显升高(

＜0.01)；患儿AKI诊断前48 h及24 h尿NGAL预测诊断AKI的AUC分别为0.728，95%

(0.630

0.825)和0.943，95%

(0.903

0.983)；诊断前24 h血浆NGAL预测诊断AKI的AUC为0.823，95%

(0.751

0.895)。

结论

脓毒症AKI患儿尿液及血浆NGAL明显升高，其尿及血浆中NGAL水平升高对AKI具有中到高度的预测诊断价值。

Abstract

Objective

To investigate the dynamic concentration of neutrophil gelatinase associated lipocalin (NGAL) in the plasma and urine of pediatric patients with sepsis

and explore the diagnosis value of NGAL in acute kidney injury (AKI) caused by sepsis.

Methods

One hundred and fifty pediatric patients with normal kidney function from the intensive care unit (ICU) were enrolled in this study from July 2013 to July 2016. Plasma and urine NGAL was detected at 9 a.m. every day from the ICU admission (D1) to the sixth day (D6)

and serum creatinine (SCr) concentration was detected at 9 a.m. every day from D1 to the seventh day (D7). The incidence of AKI was determined based on KDIGO criteria in 2012

and the patients were assigned to AKI group and control group. The predictive diagnotic value of NGAL in the plasma and urine for AKI was determined with reciever operative characteristic (ROC) analysis and the area under curve (AUC) in 72

48 and 24 h before AKI diagnosis.

Results

Among the enrolled 150 septic children

52 children were diagnosed with sepsis-induced AKI and the incidence rate was 34.6%. The plasma and urine NGAL concentration was elevated at 24 and 48 h

and was higher than that at 72 h before AKI diagnosis (

＜0.01). The AUCs of the urine NGAL for AKI diagnosis at 48 and 24 h were 0.728 with 95%

(0.630

0.825) and 0.943 with 95%

(0.903

0.983)

respectively

while the AUC of the plasma NGAL for AKI diagnosis at 24 h was 0.823 with 95%

(0.751

0.895).

Conclusion

In the pediatric patients with sepsis-induced AKI

the urine and plasma NGAL concentration is increased significantly

which has high value for diagnosis of sepsis-induced AKI.

关键词

人中性粒细胞明胶酶相关性脂质运载蛋白脓毒症儿童急性肾损伤

Keywords

neutrophil gelatinase associated lipocalinsepsischildrenacute kidney injury

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