本文關(guān)鍵詞： 人中性粒細胞明膠酶相關(guān)性脂質(zhì)運載蛋白 膿毒癥 兒童 急性腎損傷　出處：《第三軍醫(yī)大學(xué)學(xué)報》2017年02期 　論文類型：期刊論文

【摘要】：目的觀察重癥監(jiān)護室(intensive care unit,ICU)中膿毒癥患兒診斷急性腎損傷(acute kidney injury,AKI)前血漿及尿中人中性粒細胞明膠酶相關(guān)性脂質(zhì)運載蛋白(neutrophil gelatinase associated lipocalin,NGAL)水平變化,并探討其對膿毒癥AKI預(yù)測診斷價值。方法納入成都婦女兒童中心醫(yī)院2013年7月至2016年7月ICU收治的150例腎功能正常膿毒癥患兒。分別于患兒進入ICU時(D1)至第6天(D6)上午9時左右取患兒新鮮尿液及靜脈血檢測血漿及尿液中NGAL水平;入ICU時(D1)至第7天(D7)上午9時檢測血清肌酐(serum creatinine,SCr)水平。根據(jù)全球改善腎臟病預(yù)后組織(KDIGO)2012年標準將膿毒癥患兒分為AKI組和非AKI組;采用ROC曲線下面積(area under curve,AUC)分析患兒AKI診斷前72、48、24 h血漿及尿NGAL對AKI的預(yù)測診斷價值。結(jié)果 150例膿毒癥患兒中,ICU 7 d內(nèi)52例患兒診斷AKI,其發(fā)生率為34.6%;患兒AKI診斷前48、24 h尿和血漿中NGAL水平較診斷前72 h明顯升高(P0.01);患兒AKI診斷前48 h及24 h尿NGAL預(yù)測診斷AKI的AUC分別為0.728,95%CI(0.630,0.825)和0.943,95%CI(0.903,0.983);診斷前24 h血漿NGAL預(yù)測診斷AKI的AUC為0.823,95%CI(0.751,0.895)。結(jié)論膿毒癥AKI患兒尿液及血漿NGAL明顯升高,其尿及血漿中NGAL水平升高對AKI具有中到高度的預(yù)測診斷價值。
[Abstract]:Objective to observe the changes of neutrophil gelatinase associated lipocalin NGALs in plasma and urine of children with sepsis in intensive care unit before diagnosis of acute renal injury. Methods 150 patients with normal renal function sepsis treated by ICU from July 2013 to July 2016 in Chengdu Women and Children's Central Hospital were enrolled in this study. After entering ICU, the patients were divided into two groups: D1) and D6 days. The fresh urine and venous blood were collected at 9:00 to detect the level of NGAL in plasma and urine. Serum creatinine creatinine (SCR) level was detected at 9:00. According to the global standard of improving prognosis of renal disease, children with sepsis were divided into AKI group and non-#en2# group according to 2012 standard. The area under ROC curve was used to analyze the predictive value of NGAL in plasma and urine for 24 hours before diagnosis of AKI in children with AKI. Results 52 of 150 children with sepsis were diagnosed by AUC within 7 days, the incidence rate was 34.6 and before diagnosis of AKI. The levels of NGAL in urine and plasma at 24 h after diagnosis were significantly higher than those in 72 h before diagnosis (P 0.01), the AUC of predictive diagnosis of AKI 48 h and 24 h before diagnosis of AKI by urinary NGAL were 0.72895% and 0.943 995% respectively) and 0.903 + 0.983C at 24 h before diagnosis, and the AUC of AKI predicted by plasma NGAL 24 hours before diagnosis was 0.823 95CIT 0.751T 0.8950.Conclusion AKI with sepsis can be diagnosed. The levels of NGAL in urine and plasma were significantly increased in children. Elevated levels of NGAL in urine and plasma are of medium to high predictive value for AKI.
【作者單位】： 成都市婦女兒童中心醫(yī)院兒童重癥醫(yī)學(xué)科;四川省人民醫(yī)院兒科;
【分類號】：R720.597;R726.9

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