重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
18期
2506-2508
,共3页
肾疾病%脂笼蛋白质类%半胱氨酸蛋白酶抑制剂%生物学标记%预测%SICU
腎疾病%脂籠蛋白質類%半胱氨痠蛋白酶抑製劑%生物學標記%預測%SICU
신질병%지롱단백질류%반광안산단백매억제제%생물학표기%예측%SICU
kidney disease%lipocalins%cysteine proteinase inhibitors%biological makers%forecasting%surgical intensive care u-nits
目的：为了评估和比较血中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、血清半胱氨酸蛋白酶抑制剂C（CysC）水平在外科重症监护室（SICU ）内成年急性肾损伤（AKI）患者的早期诊治中的应用价值。方法100例患者被分入两个组：非AKI组63例和AKI组37例，应用酶联免疫吸附法（ELISA）、胶乳增强免疫比浊法（PETIA）分别测定两组患者入SICU 时（T0）、入SICU后24 h（T1）两个时间点血NGAL及CysC水平。结果 AKI组患者在 T0、T1点的血NGAL、CysC水平明显高于非 AKI组（P＜0．01）。T0时血NGAL值对于AKI的诊断价值较好，在截断值为65．95 ng／mL时，受试者工作曲线下面积（AUROC）为0．85，其诊断的敏感性为81．8％，特异性为76．2％；T1时血 NGAL水平对于 AKI的诊断价值较差，在截断值为92 ng／mL 时， AUROC为0．69，其诊断的敏感性为70．3％，特异性为57．1％。而T0、T1时的血CysC水平对于AKI的诊断价值更佳，在截断值分别为1．49 mg／L和1．47 mg／L时，其AUROC相应为0．90和0．88，其诊断的敏感性分别为89．2％、82．5％，特异性分别为83．8％、76．2％。结论血NGAL、CysC是SICU内患者预测AKI发生的早期有效新型标记物，入室时血CysC检测对于AKI的早期诊断价值要优于血NGAL。
目的：為瞭評估和比較血中性粒細胞明膠酶相關脂質運載蛋白（NGAL）、血清半胱氨痠蛋白酶抑製劑C（CysC）水平在外科重癥鑑護室（SICU ）內成年急性腎損傷（AKI）患者的早期診治中的應用價值。方法100例患者被分入兩箇組：非AKI組63例和AKI組37例，應用酶聯免疫吸附法（ELISA）、膠乳增彊免疫比濁法（PETIA）分彆測定兩組患者入SICU 時（T0）、入SICU後24 h（T1）兩箇時間點血NGAL及CysC水平。結果 AKI組患者在 T0、T1點的血NGAL、CysC水平明顯高于非 AKI組（P＜0．01）。T0時血NGAL值對于AKI的診斷價值較好，在截斷值為65．95 ng／mL時，受試者工作麯線下麵積（AUROC）為0．85，其診斷的敏感性為81．8％，特異性為76．2％；T1時血 NGAL水平對于 AKI的診斷價值較差，在截斷值為92 ng／mL 時， AUROC為0．69，其診斷的敏感性為70．3％，特異性為57．1％。而T0、T1時的血CysC水平對于AKI的診斷價值更佳，在截斷值分彆為1．49 mg／L和1．47 mg／L時，其AUROC相應為0．90和0．88，其診斷的敏感性分彆為89．2％、82．5％，特異性分彆為83．8％、76．2％。結論血NGAL、CysC是SICU內患者預測AKI髮生的早期有效新型標記物，入室時血CysC檢測對于AKI的早期診斷價值要優于血NGAL。
목적：위료평고화비교혈중성립세포명효매상관지질운재단백（NGAL）、혈청반광안산단백매억제제C（CysC）수평재외과중증감호실（SICU ）내성년급성신손상（AKI）환자적조기진치중적응용개치。방법100례환자피분입량개조：비AKI조63례화AKI조37례，응용매련면역흡부법（ELISA）、효유증강면역비탁법（PETIA）분별측정량조환자입SICU 시（T0）、입SICU후24 h（T1）량개시간점혈NGAL급CysC수평。결과 AKI조환자재 T0、T1점적혈NGAL、CysC수평명현고우비 AKI조（P＜0．01）。T0시혈NGAL치대우AKI적진단개치교호，재절단치위65．95 ng／mL시，수시자공작곡선하면적（AUROC）위0．85，기진단적민감성위81．8％，특이성위76．2％；T1시혈 NGAL수평대우 AKI적진단개치교차，재절단치위92 ng／mL 시， AUROC위0．69，기진단적민감성위70．3％，특이성위57．1％。이T0、T1시적혈CysC수평대우AKI적진단개치경가，재절단치분별위1．49 mg／L화1．47 mg／L시，기AUROC상응위0．90화0．88，기진단적민감성분별위89．2％、82．5％，특이성분별위83．8％、76．2％。결론혈NGAL、CysC시SICU내환자예측AKI발생적조기유효신형표기물，입실시혈CysC검측대우AKI적조기진단개치요우우혈NGAL。
Objective To assess and compare the roles of plasma concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis and treatment of septic acute kidney injury (AKI) in adult Surgical critically ill patient . Methods One hundred patients were divided into two groups ,the group of 63 cases of AKI and AKI group of 37 cases ,plasma NGAL and Cystatin C level of the 2 groups were determined by the method of enzyme‐linked immunosorbent (ELISA) ,latex en‐hanced immune turbidimetry (PETIA) respectively on arrival in the surgical intensive care unit(SICU) (T0 ) and 24 h after arrival in SICU(T1 ) .Results Compared with patients in non AKI group ,both plasma NGAL and Cystatin C level of patients in AKI group on T0 and T1 increased significantly ,the difference between the two groups had significant statistical difference (P<0 .01);Although ,plasma NGAL on T1 performed less well (AUC=0 .69) ,with a threshold value of 92 ng/mL(70 .3% sensitivity ,57%specificity) .Plasma NGAL showed significant discrimination for AKI diagnosis (AUC=0 .85) with a threshold value of 65 .95 ng/mL(81 .8% sensitivity ,76 .2% specificity) on T0 .Both plasma Cystatin C on T0 and T1 worked well for the diagnosis of AKI (AUC=0 .90 ,0 .88 ,thresholds 1 .49 and 1 .47 mg/L ,respectively) ,with diagnostic sensitivity of 89 .2% ,82 .5% respectively ,speci‐ficity of 83 .8% ,76 .2% respectively .Conclusion Plasma NGAL and Cystatin C are useful markers in predicting AKI in surgical critically ill patients ,the early diagnosis value of plasma Cystatin C for AKI is better than plasma NGAL on arrival in the surgical intensive care unit .
