临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
8期
740-744
,共5页
钟发展%高岩%邓会英%廖欣
鐘髮展%高巖%鄧會英%廖訢
종발전%고암%산회영%료흔
中性粒细胞明胶酶相关脂质运载蛋白%尿肾损伤分子-1%急性肾损伤%危重病%儿童
中性粒細胞明膠酶相關脂質運載蛋白%尿腎損傷分子-1%急性腎損傷%危重病%兒童
중성립세포명효매상관지질운재단백%뇨신손상분자-1%급성신손상%위중병%인동
acute renal injury%neutrophil gelatinase-associated lipocalin%kidney injury molecule-1%critically ill pa-tients%child
目的：探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿肾损伤分子-1(KIM-1)在预测重症患儿急性肾损伤(AKI)中的意义。方法以慢性肾病(CKD)患儿、重症患儿为研究对象，随机分为重症AKI组(n=27)，重症非AKI组(n=30)，CKD组(n=30)，以健康体检儿童为对照组(n=30)，测定比较尿NGAL和KIM-1水平以及其他生化指标。结果重症AKI组的尿NGAL在AKI发生前2天(第-2天)已达峰值，比第-3天的基础值升高超过10倍，并在AKI发生后第2天降至基础值；KIM-1水平在AKI发生前1天(第-1天)升至峰值，比第-3天的基础值升高超过5倍，并保持升高至AKI发生后2 d；NGAL、KIM-1水平随时间变化(-3d~2d)的差异均有统计学意义(P均<0.01)。重症非AKI组、CKD组、对照组的尿NGAL和KIM-1水平随时间变化的差异均无统计学意义(P>0.05)。尿KIM-1、NGAL单独作为标记物诊断AKI时，受试者工作特征曲线(ROC曲线)曲线下面积(AUC)分别为：0.878和0.955(P<0.01)，而联合二者诊断AKI时，AUC为0.984(P<0.01)。尿KIM和NGAL升高倍数和CCr谷值呈负相关，Spearman相关系数分别为-0.68和-0.74(P<0.01)。结论联合检测尿NGAL和KIM-1水平可能有助于预测AKI。
目的：探討尿中性粒細胞明膠酶相關脂質運載蛋白(NGAL)和尿腎損傷分子-1(KIM-1)在預測重癥患兒急性腎損傷(AKI)中的意義。方法以慢性腎病(CKD)患兒、重癥患兒為研究對象，隨機分為重癥AKI組(n=27)，重癥非AKI組(n=30)，CKD組(n=30)，以健康體檢兒童為對照組(n=30)，測定比較尿NGAL和KIM-1水平以及其他生化指標。結果重癥AKI組的尿NGAL在AKI髮生前2天(第-2天)已達峰值，比第-3天的基礎值升高超過10倍，併在AKI髮生後第2天降至基礎值；KIM-1水平在AKI髮生前1天(第-1天)升至峰值，比第-3天的基礎值升高超過5倍，併保持升高至AKI髮生後2 d；NGAL、KIM-1水平隨時間變化(-3d~2d)的差異均有統計學意義(P均<0.01)。重癥非AKI組、CKD組、對照組的尿NGAL和KIM-1水平隨時間變化的差異均無統計學意義(P>0.05)。尿KIM-1、NGAL單獨作為標記物診斷AKI時，受試者工作特徵麯線(ROC麯線)麯線下麵積(AUC)分彆為：0.878和0.955(P<0.01)，而聯閤二者診斷AKI時，AUC為0.984(P<0.01)。尿KIM和NGAL升高倍數和CCr穀值呈負相關，Spearman相關繫數分彆為-0.68和-0.74(P<0.01)。結論聯閤檢測尿NGAL和KIM-1水平可能有助于預測AKI。
목적：탐토뇨중성립세포명효매상관지질운재단백(NGAL)화뇨신손상분자-1(KIM-1)재예측중증환인급성신손상(AKI)중적의의。방법이만성신병(CKD)환인、중증환인위연구대상，수궤분위중증AKI조(n=27)，중증비AKI조(n=30)，CKD조(n=30)，이건강체검인동위대조조(n=30)，측정비교뇨NGAL화KIM-1수평이급기타생화지표。결과중증AKI조적뇨NGAL재AKI발생전2천(제-2천)이체봉치，비제-3천적기출치승고초과10배，병재AKI발생후제2천강지기출치；KIM-1수평재AKI발생전1천(제-1천)승지봉치，비제-3천적기출치승고초과5배，병보지승고지AKI발생후2 d；NGAL、KIM-1수평수시간변화(-3d~2d)적차이균유통계학의의(P균<0.01)。중증비AKI조、CKD조、대조조적뇨NGAL화KIM-1수평수시간변화적차이균무통계학의의(P>0.05)。뇨KIM-1、NGAL단독작위표기물진단AKI시，수시자공작특정곡선(ROC곡선)곡선하면적(AUC)분별위：0.878화0.955(P<0.01)，이연합이자진단AKI시，AUC위0.984(P<0.01)。뇨KIM화NGAL승고배수화CCr곡치정부상관，Spearman상관계수분별위-0.68화-0.74(P<0.01)。결론연합검측뇨NGAL화KIM-1수평가능유조우예측AKI。
Objective To test the predicative roles of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1( KIM-1 ) for acute kidney injury (AKI) in critically ill patients. Methods Children from pediatric intensive care unit, were randomly divided into four groups:critically ill patients with AKI (group 1 ), critically ill patients with non-AKI (group 2) , chronic kidney disease group (group 3), healthy control group (group 4). 1.5 ml venous blood and urine specimens were collected and kept under-70°C. Serum creatinine , urine NGAL and urine KIM-1 were analyzed. Results Compared with group 2, group 3 and group 4, the urine NGAL and urine KIM-1 increases obviously in group 1 (P<0.05). There is no signiifcance of urine NGAL and urine KIM-1 between group2, group3 and group 4 (P>0.05). The concentration of urine NGAL increased more than 10 times of base-line level 2 days before the diagnosis of AKI under the Acute Kidney Injury Network standard with area under curve (AUC) 0.955 (P<0.05) , and the concentration of urine KIM-1 increased more than 5 times of base-line level 1 day before AKI with AUC 0.878 (P<0.05). The AUC was 0.984 (P<0.01) when they were combined. There is negative correlation between the increased times of urinary KIM-1, urinary NGAL and vally value of creatin clearance rate. Conclusions The concentrations of urine NGAL and urine KIM-1 are useful early biomarkers for predicting AKI, especially when they were combined.
