本文選題：中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白 + 腎損傷分子-�。� 參考：《中國(guó)全科醫(yī)學(xué)》2017年31期

【摘要】：目的探討尿中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白(NGAL)和腎損傷分子-1(KIM-1)在流行性出血熱(EHF)合并急性腎損傷(AKI)早期診斷中的價(jià)值。方法選取2014年1月—2016年11月濟(jì)寧醫(yī)學(xué)院附屬醫(yī)院腎內(nèi)科、ICU、呼吸科及血液科收治的符合納入排除標(biāo)準(zhǔn)的41例EHF患者。根據(jù)AKI的診斷標(biāo)準(zhǔn),將患者分為非AKI組和AKI組,收集兩組確診時(shí)、確診后不同時(shí)間點(diǎn)的血清肌酐(Scr)、尿NGAL、尿KIM-1水平。采用受試者工作特征(ROC)曲線評(píng)價(jià)尿NGAL和尿KIM-1對(duì)EHF合并AKI的早期診斷價(jià)值。結(jié)果 41例EHF患者中,合并AKI者26例(63.4%)。兩組患者確診時(shí)Scr、確診時(shí)尿KIM-1水平比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者Scr水平在確診后24、48、72 h比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);尿NGAL水平在確診時(shí)及確診后2、4、8、12、24h比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);尿KIM-1水平在確診后2、4、8、12、24 h比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。Pearson相關(guān)分析顯示,確診后2 h尿KIM-1水平、確診后2 h尿NGAL水平與確診后24 h Scr水平呈正相關(guān)(r值分別為0.673、0.846,P0.01)。確診后2 h尿NGAL診斷EHF合并AKI的ROC曲線下面積為0.822[95%CI(0.692,0.952)],截點(diǎn)值為40.15 pg/ml;確診后2 h尿KIM-1的曲線下面積為0.785[95%CI(0.643,0.927)],截點(diǎn)值為0.55 pg/ml。結(jié)論尿NGAL和尿KIM-1可能可以作為EHF患者是否合并AKI的早期診斷標(biāo)志物。
[Abstract]:Objective to investigate the value of urinary neutrophil gelatinase-associated lipid carrier protein (NGALL) and renal injury molecule (-1) KIM-1 in the early diagnosis of acute renal injury (AKI) associated with epidemic hemorrhagic fever (EHF). Methods from January 2014 to November 2016, 41 patients with EHF who were admitted to Department of Renal Medicine, Department of Respiratory Medicine and Department of Hematology in affiliated Hospital of Jining Medical College were selected. According to the diagnostic criteria of AKI patients were divided into non-AKI group and AKI group. Serum creatinine (creatinine) urine KIM-1 levels were collected at different time points after diagnosis. The early diagnostic value of urine NGAL and urinary KIM-1 in EHF with AKI was evaluated by using the operating characteristics of subjects. Results among 41 patients with EHF, 26 cases were complicated with AKI. There was no significant difference in urine KIM-1 level between the two groups at the time of diagnosis and the level of urinary KIM-1 at the time of diagnosis (P 0.05), the level of Scr in the two groups was significantly higher than that in the control group at 24 h, 48 h after diagnosis, and the level of urinary NGAL was significantly higher than that in 24 h after diagnosis, and the level of urinary NGAL was compared between the two groups at the time of diagnosis and at 24 h after diagnosis. The difference was statistically significant (P 0.05) and the urinary KIM-1 level was significantly higher than that at 24 h after diagnosis (P 0.05). Pearson correlation analysis showed that there was a positive correlation between urinary KIM-1 level 2 h after diagnosis and 24 h Scr level at 24 h after diagnosis (r = 0.6730.846). At 2 h after diagnosis, the area under the ROC curve of EHF combined with AKI was 0.822 (95 CI 0.6920.9052), the cut-off point was 40.15 PG / ml, and the area under the curve of urine KIM-1 2 h after diagnosis was 0.785 [95CI0.643 鹵0.927], and the cut-off point was 0.55 PG / ml. Conclusion urinary NGAL and urinary KIM-1 may be used as early diagnostic markers of AKI in EHF patients.
【作者單位】： 濟(jì)寧醫(yī)學(xué)院附屬醫(yī)院;
【基金】：濟(jì)寧市科技發(fā)展計(jì)劃項(xiàng)目(2014jnnk04)
【分類號(hào)】：R512.8;R692.5
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本文編號(hào)：1985174