中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2014年
3期
166-171
,共6页
标志物,生物学%重症监护,成人%早期诊断%急性肾损伤
標誌物,生物學%重癥鑑護,成人%早期診斷%急性腎損傷
표지물,생물학%중증감호,성인%조기진단%급성신손상
Biomarkers%Patients,critical%Early diagnosis%Acute kidney injury
目的 探讨血清半胱氨酸蛋白酶抑制剂C(sCys-C)、尿中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)、尿肾损伤分子1(uKIM-1)、尿白细胞介素18(uIL-18)联合检测在成人重症患者合并急性肾损伤(AKI)早期诊断中的价值.方法 选择2011年8月至2012年12月入住聊城市第三人民医院ICU≥24 h的患者256例,以急性肾损伤网络(AKIN)标准为诊断标准,将患者分为非AKI组和AKI组(包括AKI 1期、2期3期),检测并比较各组患者sCys-C、uNGAL、uKIM-1、uIL-18水平.运用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价4项生物学标志物单独及联合检测对AKI的诊断价值.结果 (1) AKI组患者sCys-C、uKim-1、uNGAL、uIL-18水平明显高于非AKI组(均P＜0.01).(2) sCys-C、uNGAL、uKIM-1、uIL-18单独及联合诊断AKI的AUC分别为0.742、0.871、0.803、0.703、0.925.(3)4项生物学标志物并联试验检测的灵敏度、特异度分别为97.9％、62.8％,串联试验检测的灵敏度、特异度分别为64.3％、96.2％,并联试验检测的灵敏度与各单项检测的灵敏度、串联试验检测的特异度与各单项检测的特异度之间的差异有统计学意义(均P＜ 0.05).结论 尿NGAL、KIM-1、IL-18和血清Cys-C是诊断早期AKI的敏感指标,联合检测对急性肾损伤的早期诊断具有重要的价值.
目的 探討血清半胱氨痠蛋白酶抑製劑C(sCys-C)、尿中性粒細胞明膠酶相關脂質運載蛋白(uNGAL)、尿腎損傷分子1(uKIM-1)、尿白細胞介素18(uIL-18)聯閤檢測在成人重癥患者閤併急性腎損傷(AKI)早期診斷中的價值.方法 選擇2011年8月至2012年12月入住聊城市第三人民醫院ICU≥24 h的患者256例,以急性腎損傷網絡(AKIN)標準為診斷標準,將患者分為非AKI組和AKI組(包括AKI 1期、2期3期),檢測併比較各組患者sCys-C、uNGAL、uKIM-1、uIL-18水平.運用受試者工作特徵(ROC)麯線及麯線下麵積(AUC)評價4項生物學標誌物單獨及聯閤檢測對AKI的診斷價值.結果 (1) AKI組患者sCys-C、uKim-1、uNGAL、uIL-18水平明顯高于非AKI組(均P＜0.01).(2) sCys-C、uNGAL、uKIM-1、uIL-18單獨及聯閤診斷AKI的AUC分彆為0.742、0.871、0.803、0.703、0.925.(3)4項生物學標誌物併聯試驗檢測的靈敏度、特異度分彆為97.9％、62.8％,串聯試驗檢測的靈敏度、特異度分彆為64.3％、96.2％,併聯試驗檢測的靈敏度與各單項檢測的靈敏度、串聯試驗檢測的特異度與各單項檢測的特異度之間的差異有統計學意義(均P＜ 0.05).結論 尿NGAL、KIM-1、IL-18和血清Cys-C是診斷早期AKI的敏感指標,聯閤檢測對急性腎損傷的早期診斷具有重要的價值.
목적 탐토혈청반광안산단백매억제제C(sCys-C)、뇨중성립세포명효매상관지질운재단백(uNGAL)、뇨신손상분자1(uKIM-1)、뇨백세포개소18(uIL-18)연합검측재성인중증환자합병급성신손상(AKI)조기진단중적개치.방법 선택2011년8월지2012년12월입주료성시제삼인민의원ICU≥24 h적환자256례,이급성신손상망락(AKIN)표준위진단표준,장환자분위비AKI조화AKI조(포괄AKI 1기、2기3기),검측병비교각조환자sCys-C、uNGAL、uKIM-1、uIL-18수평.운용수시자공작특정(ROC)곡선급곡선하면적(AUC)평개4항생물학표지물단독급연합검측대AKI적진단개치.결과 (1) AKI조환자sCys-C、uKim-1、uNGAL、uIL-18수평명현고우비AKI조(균P＜0.01).(2) sCys-C、uNGAL、uKIM-1、uIL-18단독급연합진단AKI적AUC분별위0.742、0.871、0.803、0.703、0.925.(3)4항생물학표지물병련시험검측적령민도、특이도분별위97.9％、62.8％,천련시험검측적령민도、특이도분별위64.3％、96.2％,병련시험검측적령민도여각단항검측적령민도、천련시험검측적특이도여각단항검측적특이도지간적차이유통계학의의(균P＜ 0.05).결론 뇨NGAL、KIM-1、IL-18화혈청Cys-C시진단조기AKI적민감지표,연합검측대급성신손상적조기진단구유중요적개치.
Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C (sCys-C),urinary kidney injury molecule 1 (uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL) and urinary interleukin 18 (uIL-18) for early diagnosis of acute kidney injury (AKI) in critically ill patients.Methods A total of 256 adult patients who stayed Intensive Care Unit for 24 hours in the Third People's Hospital of Liaocheng between Aug 2011 and Dec 2012 were enrolled.According to Kidney Injury Net(AKIN) work,the patients were divided into non-AKI group and AKI group (including state 1,2 and 3).The concentrations of urine NGAL,KIM-1,IL-18 and serum sCys-C were measured.The diagnosis value of four biomarkers joint detection and single detection for AKI were analyzed with the receiver operating characteristic (ROC) curve and the area under curve (AUC).Results (1) The levels of uNGAL,uKIM-1,uIL-18 and sCys-C were higher in patients with AKI than the patients with no AKI (P ＜ 0.01).(2) The area under curves of uNGAL,uKIM-1,uIL-18,sCys-C and joint detection were 0.742,0.871,0.803,0.703,0.925 respectively.(3) The sensitivity and specificity of parallel tests and serial tests of four biomarkers were 97.9％,62.8％,64.3％ and 96.2％ respectively.There were significant differences of sensitivity or specificity between single test and joint tests.Conclusions The urine NGAL,KIM-1,IL-18 and serum Cys-C are sensitive indexes for the early diagnosis of acute kidney injury.Joint detection has high value for early diagnosis of AKI.
