NGAL、KIM-1和PCT在脓毒症AKI中的标志物作用

被引：12

作者：

刘立志 ^{[1
]}

曾梦君 ^{[2
]}

蒋继贫 ^{[2
]}

机构：

[1] 监利县人民医院

[2] 华中科技大学同济医学院附属同济医院

来源：

基因组学与应用生物学 | 2020年 / 39卷 / 03期

关键词：

脓毒症; 急性肾损伤; 生物标志物; NGAL; KIM-1; PCT;

D O I：

10.13417/j.gab.039.001408

中图分类号：

R459.7 [急症、急救处理]; R692.5 [肾功能衰竭];

学科分类号：

1002 ; 100210 ; 100218 ;

摘要：

探讨NGAL与KIM-1联合检测和PCT在重症监护病房重症患者中急性肾损伤(AKI)发生中的作用。选取2018年1月至2019年6月我院101例重症患者,其中脓毒症AKI组61例,非AKI组40例,通过分析NGAL、KIM-1和PCT在2组患者中表达水平变化情况,结合与ACR指标对比分析,评价NGAL、KIM-1和PCT在脓毒症急性肾损伤早期诊断中的价值。结果显示,所有脓毒症AKI患者均检测出明显更高的尿NGAL生物标志物水平(67.32μg/g Cr)。尿KIM-1和尿NGAL水平升高与患者ACR升高均呈正相关(p<0.001),而在脓毒症AKI患者中PCT和ACR之间观察到显著的负相关(rs=-0.102 5, p=0.307)。通过Kruskal-Wallis检验发现,NGAL和KIM-1值显示出与脓毒症严重程度具有显著统计学意义,且直接成比例的关系(p≤0.01)。进一步检查NGAL、KIM-1和PCT标志物与病情发展的相关性表明,PCT值似乎与临床结果没有很强的相关性。尿KIM-1联合NGAL在早期检测脓毒症AKI中具有较大的预测价值;PCT是有希望的脓毒症标志物之一,但不足以提供可靠诊断依据,在肾功能下降的患者中通过PCT进行脓毒症的临床诊断需要更加谨慎。

引用

页码：1408 / 1413

页数：6

共 15 条

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