国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2013年
1期
47-50
,共4页
肾疾病%肺移植
腎疾病%肺移植
신질병%폐이식
Kidney Diseases%Lung Transplantation
目的 探讨尿肾损伤分子-1(KIM-1)在肺移植术后急性肾损伤(AKI)中的早期诊断价值.方法 前瞻性收集本院52例肺移植手术患者在手术前后不同时相的血、尿标本,分别测定血肌酐(Scr)和尿KIM-1.根据AKI的诊断标准,将患者分为AKI组和非AKI组,观察两组Scr和尿KIM-1的动态变化.用受试者工作特征曲线(ROC)评价尿KIM-1对AKI的诊断作用.结果 52例患者中,术后发生AKI的有19例,发生率为36.5％.AKI组Scr在术后的第24h上升至基础值的1.80倍,达到AKI的诊断标准.AKI组术后4h尿KIM-1较基线值明显上升[(1.7±0.6) ng/mL比(0.5±0.3)ng/mL,P＜0.05].术后4h,尿KIM-1的ROC曲线下面积为0.837,95％的可信区间为0.729～0.946,以1.6ng/mL作为AKI的诊断界限时,敏感性和特异性分别为73.7％和75.8％.结论 尿KIM-1可较Scr更早诊断肺移植术后AKI的发生.尿KIM-1可能为肺移植术后并发AKI患者的早期诊断的标记物.
目的 探討尿腎損傷分子-1(KIM-1)在肺移植術後急性腎損傷(AKI)中的早期診斷價值.方法 前瞻性收集本院52例肺移植手術患者在手術前後不同時相的血、尿標本,分彆測定血肌酐(Scr)和尿KIM-1.根據AKI的診斷標準,將患者分為AKI組和非AKI組,觀察兩組Scr和尿KIM-1的動態變化.用受試者工作特徵麯線(ROC)評價尿KIM-1對AKI的診斷作用.結果 52例患者中,術後髮生AKI的有19例,髮生率為36.5％.AKI組Scr在術後的第24h上升至基礎值的1.80倍,達到AKI的診斷標準.AKI組術後4h尿KIM-1較基線值明顯上升[(1.7±0.6) ng/mL比(0.5±0.3)ng/mL,P＜0.05].術後4h,尿KIM-1的ROC麯線下麵積為0.837,95％的可信區間為0.729～0.946,以1.6ng/mL作為AKI的診斷界限時,敏感性和特異性分彆為73.7％和75.8％.結論 尿KIM-1可較Scr更早診斷肺移植術後AKI的髮生.尿KIM-1可能為肺移植術後併髮AKI患者的早期診斷的標記物.
목적 탐토뇨신손상분자-1(KIM-1)재폐이식술후급성신손상(AKI)중적조기진단개치.방법 전첨성수집본원52례폐이식수술환자재수술전후불동시상적혈、뇨표본,분별측정혈기항(Scr)화뇨KIM-1.근거AKI적진단표준,장환자분위AKI조화비AKI조,관찰량조Scr화뇨KIM-1적동태변화.용수시자공작특정곡선(ROC)평개뇨KIM-1대AKI적진단작용.결과 52례환자중,술후발생AKI적유19례,발생솔위36.5％.AKI조Scr재술후적제24h상승지기출치적1.80배,체도AKI적진단표준.AKI조술후4h뇨KIM-1교기선치명현상승[(1.7±0.6) ng/mL비(0.5±0.3)ng/mL,P＜0.05].술후4h,뇨KIM-1적ROC곡선하면적위0.837,95％적가신구간위0.729～0.946,이1.6ng/mL작위AKI적진단계한시,민감성화특이성분별위73.7％화75.8％.결론 뇨KIM-1가교Scr경조진단폐이식술후AKI적발생.뇨KIM-1가능위폐이식술후병발AKI환자적조기진단적표기물.
Objectives To investigate the value of kidney injury molecule-1 (KIM-1) in the early diagnosis of early-stage acute kidney injury (AKI) in patients after lung transplantation.Methods 52 lung transplantation patients hospitalized were enrolled in this prospective study.Blood and urine samples were collected before and at different time points after surgery.The concentrations of serum creatinine (Scr) and urine KIM-1 were measured.According to AKI criteria,patients were divided into the AKI group and non-AKI group.Dynamic changes of levels of Scr and urine KIM-1 were observed in two groups.The receiver operating characteristic curve was used to evaluate the early diagnostic value of urine KIM-1.Results 19 (36.5％) patients developed AKI after lung transplantation.24h after surgery,the level of Scr rose to 1.80 times of the baseline,which met the diagnostic criteria of AKI.In the AKI group,concentrations of urine KIM-1 at 4h time point began to rise significantly from baseline[(1.7 ±0.6) ng/mL versus (0.5 ±0.3) ng/mL,P ＜0.05].At 4h time point after lung transplantation,the area under the curve of urine KIM-1 was 0.837 (95 ％ CI 0.729 ～ 0.946),the sensitivity was 73.7 ％ and specificity was 75.8％ with a cutoff value of 1.6ng/mL.Conclusions Urine KIM-1 can diagnose AKI after lung transplantation earlier than Scr,which may be a good biomarker for early diagnosis of AKI after lung transplantation.
