国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
10期
678-682
,共5页
游莉%唐靖%肖金仿%古妙宁
遊莉%唐靖%肖金倣%古妙寧
유리%당정%초금방%고묘저
肝移植%急性肾损伤%乳酸脱氢酶%胱抑素C%中性粒细胞明胶酶相关脂质运载蛋白
肝移植%急性腎損傷%乳痠脫氫酶%胱抑素C%中性粒細胞明膠酶相關脂質運載蛋白
간이식%급성신손상%유산탈경매%광억소C%중성립세포명효매상관지질운재단백
Liver transplantation%Acute kidney injury%Lactate dehydrogenase%Cystatin C%Neutrophil gelatinaseassociated lipocalin
目的 探讨尿液中乳酸脱氢酶(lactate dehydrogenase,LDH)、胱抑素C(cystatin C,Cys-C)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)对于肝移植患者术后急性肾损伤(acute kindey injury,AKI)早期诊断价值.方法 收集2011年1月～2011年10月在南方医院接受同种异体肝移植术的45例终末期肝病患者术前及手术结束时的静脉血液及尿液标本,检测血清肌酐( serum creatinine,SCr)、胱抑素、LDH及总胆红素,检测尿液中LDH、胱抑素、NGAL.根据AKI网络标准中的SCr标准将患者分为AKI组和非AKI组.比较两组术前、术后尿液中LDH、Cys-C、NGAL的变化情况,并运用受试者工作曲线(receiver operating characteristic curve,ROC)评价LDH、Cys-C、NGAL的准确性.结果 45例患者中20例发生了术后AKI,两组患者的年龄、性别、术前的基本情况、术中手术情况比较差异无统计学意义.AKI组和非AKI组术后血清SCr的差异具有统计学意义[(140±54)比(81±20),P＜0.05].术后AKI组及非AKI组尿液中的LDH、Cys-C、NGAL均升高,AKI组增加明显高于非AKI组.AKI组尿液中LDH、Cys-C、NGAL高于非AKI组,且差异具有统计学意义[(6.50±2.86)比(3.21±1.63),P＜0.05]、[(1.55±0.54)比(0.86±0.31),P＜0.05]、[(107±59)比(43±11),P＜0.05].ROC下面积结果显示,尿液中的LDH、Cys-C、NGAL均显示出了较好的诊断意义,面积分别为0.853、0.833、0.880,大于0.8. 结论 LDH、Cys-C、NGAL均表现出了较好的敏感性和特异性.
目的 探討尿液中乳痠脫氫酶(lactate dehydrogenase,LDH)、胱抑素C(cystatin C,Cys-C)、中性粒細胞明膠酶相關脂質運載蛋白(neutrophil gelatinase-associated lipocalin,NGAL)對于肝移植患者術後急性腎損傷(acute kindey injury,AKI)早期診斷價值.方法 收集2011年1月～2011年10月在南方醫院接受同種異體肝移植術的45例終末期肝病患者術前及手術結束時的靜脈血液及尿液標本,檢測血清肌酐( serum creatinine,SCr)、胱抑素、LDH及總膽紅素,檢測尿液中LDH、胱抑素、NGAL.根據AKI網絡標準中的SCr標準將患者分為AKI組和非AKI組.比較兩組術前、術後尿液中LDH、Cys-C、NGAL的變化情況,併運用受試者工作麯線(receiver operating characteristic curve,ROC)評價LDH、Cys-C、NGAL的準確性.結果 45例患者中20例髮生瞭術後AKI,兩組患者的年齡、性彆、術前的基本情況、術中手術情況比較差異無統計學意義.AKI組和非AKI組術後血清SCr的差異具有統計學意義[(140±54)比(81±20),P＜0.05].術後AKI組及非AKI組尿液中的LDH、Cys-C、NGAL均升高,AKI組增加明顯高于非AKI組.AKI組尿液中LDH、Cys-C、NGAL高于非AKI組,且差異具有統計學意義[(6.50±2.86)比(3.21±1.63),P＜0.05]、[(1.55±0.54)比(0.86±0.31),P＜0.05]、[(107±59)比(43±11),P＜0.05].ROC下麵積結果顯示,尿液中的LDH、Cys-C、NGAL均顯示齣瞭較好的診斷意義,麵積分彆為0.853、0.833、0.880,大于0.8. 結論 LDH、Cys-C、NGAL均錶現齣瞭較好的敏感性和特異性.
목적 탐토뇨액중유산탈경매(lactate dehydrogenase,LDH)、광억소C(cystatin C,Cys-C)、중성립세포명효매상관지질운재단백(neutrophil gelatinase-associated lipocalin,NGAL)대우간이식환자술후급성신손상(acute kindey injury,AKI)조기진단개치.방법 수집2011년1월～2011년10월재남방의원접수동충이체간이식술적45례종말기간병환자술전급수술결속시적정맥혈액급뇨액표본,검측혈청기항( serum creatinine,SCr)、광억소、LDH급총담홍소,검측뇨액중LDH、광억소、NGAL.근거AKI망락표준중적SCr표준장환자분위AKI조화비AKI조.비교량조술전、술후뇨액중LDH、Cys-C、NGAL적변화정황,병운용수시자공작곡선(receiver operating characteristic curve,ROC)평개LDH、Cys-C、NGAL적준학성.결과 45례환자중20례발생료술후AKI,량조환자적년령、성별、술전적기본정황、술중수술정황비교차이무통계학의의.AKI조화비AKI조술후혈청SCr적차이구유통계학의의[(140±54)비(81±20),P＜0.05].술후AKI조급비AKI조뇨액중적LDH、Cys-C、NGAL균승고,AKI조증가명현고우비AKI조.AKI조뇨액중LDH、Cys-C、NGAL고우비AKI조,차차이구유통계학의의[(6.50±2.86)비(3.21±1.63),P＜0.05]、[(1.55±0.54)비(0.86±0.31),P＜0.05]、[(107±59)비(43±11),P＜0.05].ROC하면적결과현시,뇨액중적LDH、Cys-C、NGAL균현시출료교호적진단의의,면적분별위0.853、0.833、0.880,대우0.8. 결론 LDH、Cys-C、NGAL균표현출료교호적민감성화특이성.
Objective To investigate the value of urinary lactate dehydrogenase(LDH),Cystatin C (Cys-C) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of acute kidney injury after liver transplantation. Methods From January 2011 to October 2011,45 patients were recruited.Blood and urinary samples were collected before operation and the end of the operation,and used to determine serum creatinine (SCr),Cys-C,LDH,and total bilirubin,as well as urinary LDH,Cys-C and NGAL.All the patients were divided into AKI and non-AKI groups,according to the Acute Kidney Injury Network (AKIN) criteria of AKI.The statistics were used along ROC analysis to evaluate the diagnose value of selected biomarkers. Results There were no significant differences in clinical parameters between AKI and non-AKI groups while 20 of the 45 patients suffered AKI [ ( 140±54)vs (81±20),P＜0.05].Urine LDH,Cys-C and NGAL raised in all the samples,and the level of the 3 enzymes in AKI group increased significantly [ (6.50±2.86)vs (3.21±1.63),P＜0.05 ],[ ( 1.55±0.54)vs (0.86±0.31),P＜0.05 ],[ ( 107±59)vs (43±11 ),P＜0.05 ].ROC analysis revealed that (AUC 0.853,0.833,0.880) the 3 enzymes are capable of early diagnosis of AKI. Conclusions Urinary LDH,Cys-C and NGAL appear to be sensitive and specific biomarkers of AKI in liver transplant recipients,but further research are needed in the future for the clinical diagnosis.
