尿NGAL和KIM-1及IL-18在脓毒症并发急性肾损伤中的早期诊断价值

张盼; 赵会海; 郝玉青; 张海谱

doi:10.13201/j.issn.1009-5918.2019.07.009

尿NGAL和KIM-1及IL-18在脓毒症并发急性肾损伤中的早期诊断价值

- 中国人民解放军联勤保障部队第九八〇医院检验科(石家庄, 050082)

详细信息

通讯作者: 张海谱,E-mail:38221091@qq.com

中图分类号: R692

收稿日期: 2019-04-23

Early diagnosis value of urinary NGAL and KIM-1 and IL-18 in sepsis complicated with acute kidney injury

- Department of Clinical Laboratory, Ninety-eighty Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Shijiazhuang, 050082, China

More Information

Corresponding author: ZHANG Haipu, E-mail: 38221091@qq.com

Received Date: 23 April 2019

摘要

摘要: 目的: 探讨尿肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及白细胞介素-18(IL-18)对脓毒症并发急性肾损伤(AKI)的早期诊断价值。方法: 选取2017-01—2019-12期间本院收治的脓毒症患者216例,依据其是否发生AKI,分为AKI组(74例)和非AKI组(142例)。采用酶联免疫吸附法测定患者0h、12h、24h尿NGAL、KIM-1及IL-18水平。应用受试者工作特征(ROC)曲线分析不同时间点尿NGAL、KIM-1及IL-18水平对AKI的早期诊断价值。结果: 在12h、24h时间点,AKI组尿NGAL、KIM-1及IL-18水平均明显高于非AKI组(P<0.05)。ROC曲线分析显示,12h尿KIM-1、NGAL及IL-18水平诊断AKI的AUC分别为0.863(95%CI:0.812~0.917)、0.834(95%CI:0.778~0.892)、0.768(95%CI:0.713~0.830),其最佳截断值分别为653.70ng/ml、39.20pg/ml、23.60pg/ml。12h尿NGAL、KIM-1及IL-18三项联合诊断AKI的AUC(0.937,95%CI:0.883~0.992)最大,其敏感度和特异度最好,为94.5%和87.0%。Pearson相关分析显示,AKI患者尿12hNGAL水平与KIM-1及IL-18水平均呈正相关(r=0.736,r=0.658,P<0.01),AKI患者尿24hNGAL水平与KIM-1及IL-18水平均呈正相关(r=0.694,r=0.617,P<0.01)。结论: 12h尿NGAL、KIM-1及IL-18水平在脓毒症并发AKI患者中明显升高,三项联合检测对AKI早期诊断的价值较高。
- 脓毒症 /
- 急性肾损伤 /
- 中性粒细胞明胶酶相关脂质运载蛋白 /
- 肾损伤分子-1 /
- 白细胞介素-18 /
- 早期诊断
Abstract: Objective: To investigate the early diagnosis value of urinary kidney injury molecular-1(KIM-1),neutrophil gelatinase-related lipid delivery protein(NGAL)and interleukin-18(IL-18)in patients with acute kidney injury(AKI)complicated by sepsis.Method: Two hundred and sicteen patients with sepsis admitted to our hospital from January 2017 to December 2019 were divided into AKI group(74 cases)and non-AKI group(142 cases)according to the occurrence of AKI.Urine NGAL,KIM-1 and IL-18 levels were measured at 0,12 and 24 hours by ELISA.The early diagnostic value of urinary NGAL,KIM-1 and IL-18 levels at different time points for AKI was analyzed by ROC curve.Result: At 12 hours and 24 hours,urinary NGAL,KIM-1 and IL-18 levels in AKI group were significantly higher than those in non-AKI group(P<0.05).ROC curve analysis showed that the AUC of 12 hours urinary KIM-1,NGAL and IL-18 levels for diagnosis of AKI were 0.863(95%CI:0.812-0.917),0.834(95%CI:0.778-0.892),0.768(95%CI:0.713-0.830),and the best cut-off values were 653.70 ng/ml,39.20 pg/ml and 23.60 pg/ml,respectively.The AUC(0.937,95%CI:0.883-0.992)of 12 hours urinary NGAL,KIM-1 and IL-18 combined diagnosis of AKI was the largest,and its sensitivity and specificity were the best(94.5% and 87.0%).Pearson correlation analysis showed that 12 hours urine NGAL level was positively correlated with both KIM-1 and IL-18 levels in AKI patients(r=0.736,r=0.658,P<0.01),and 24 hours urine NGAL level was positively correlated with both KIM-1 and IL-18 levels in AKI patients(r=0.694,r =0.617,P<0.01).Conclusion: The 12 hours urine NGAL,KIM-1 and IL-18 levels are significantly increased in patients with sepsis complicated with AKI,and Three combined tests are of high value for the early diagnosis of AKI.
- sepsis /
- acute kidney injury /
- neutrophil gelatinase related lipid carrier protein /
- kidney injury molecule-1 /
- interleukin-18 /
- early diagnosis

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