[1]田爱民,王美蓉,车吉忠,等.尿中性粒细胞明胶酶相关脂质运载蛋白、肝型脂肪酸结合蛋白对成人泌尿系统疾病致急性肾损伤诊断价值及检测临床意义[J].陕西医学杂志,2023,52(11):1588-1592.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.030]
 TIAN Aimin,WANG Meirong,CHE Jizhong,et al.Diagnostic value and clinical significance of urinary NGAL and L-FABP in adult patients with acute kidney injury caused by urinary system diseases[J].,2023,52(11):1588-1592.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.030]
点击复制

尿中性粒细胞明胶酶相关脂质运载蛋白、肝型脂肪酸结合蛋白对成人泌尿系统疾病致急性肾损伤诊断价值及检测临床意义
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年11期
页码:
1588-1592
栏目:
临床检验
出版日期:
2023-11-05

文章信息/Info

Title:
Diagnostic value and clinical significance of urinary NGAL and L-FABP in adult patients with acute kidney injury caused by urinary system diseases
作者:
田爱民王美蓉车吉忠徐延凯
(滨州医学院烟台附属医院,山东 烟台 264000)
Author(s):
TIAN AiminWANG MeirongCHE JizhongXU Yankai
(Yantai Affiliated Hospital,Binzhou Medical College,Yantai 264000,China)
关键词:
中性粒细胞明胶酶相关脂质运载蛋白 肝型脂肪酸结合蛋白 泌尿系统疾病 急性肾损伤 诊断 尿液
Keywords:
Neutrophil gelatinase related lipid carrier protein Liver type fatty acid binding protein Urinary system disease Acute kidney injury Diagnosis Urine
分类号:
R 692.9
DOI:
DOI:10.3969/j.issn.1000-7377.2023.11.030
文献标志码:
A
摘要:
目的:探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)对成人泌尿系统疾病致急性肾损伤(AKI)的诊断价值及检测临床意义。方法:选取115例泌尿系统疾病患者为研究对象。根据是否发生AKI分为AKI组48例、非AKI组67例。比较AKI组和非AKI组患者一般资料,测定血清肌酐(Scr)、尿素氮(BUN)、白蛋白(Alb)、血红蛋白(Hb)及尿NGAL、L-FABP水平。采用Logistic回归模型分析泌尿系统疾病患者发生AKI的危险因素,Spearman相关分析AKI组尿NGAL、L-FABP与Scr的相关性,ROC曲线评估尿NGAL和L-FABP水平对AKI的诊断价值。结果:AKI组APACHEⅡ评分、尿L-FABP、NGLA及血清Scr、BUN水平高于非AKI组,eGFR水平低于非AKI组(均P<0.05)。Logistic多因素回归分析显示eGFR和血清Scr、BUN及尿NGAL、L-FABP水平均为泌尿系统疾病患者发生AKI的独立危险因素(均P<0.05)。尿NGAL、L-FABP水平与Scr呈正相关(r=0.609、0.817,均P<0.001)。尿NGAL、L-FABP联合检测对泌尿系统疾病患者发生AKI的诊断效能优于单独检测,尿NGAL诊断AKI的曲线下面积为0.803,灵敏度79.17%,特异度70.83%。尿L-FABP的曲线下面积为0.817,灵敏度为81.25%,特异度66.67%,联合检测曲线下面积为0.887,灵敏度87.50%,特异度77.08%(P<0.001)。结论:泌尿系统疾病所致AKI患者尿液中L-FABP、NGAL指标水平上升,尿NGAL、L-FABP联合检测更有利于诊断AKI。
Abstract:
Objective:To investigate the diagnostic value and clinical significance of urinary neutrophil gelatinase related lipid transporter(NGAL)and hepatic fatty acid binding protein(L-FABP)in adult patients with acute kidney injury(AKI)caused by urinary system diseases.Methods:A total of 115 patients with urinary system diseases were selected as the study subjects.According to the presence or absence of AKI,the patients were divided into AKI group(48 cases)and non-AKI group(67 cases).The general data of patients in AKI group and non-AKI group were compared,and serum creatinine(Scr),blood urea nitrogen(BUN),albumin(Alb),hemoglobin(Hb),urinary NGAL and L-FABP levels were measured.Logistic regression model was used to analyze the risk factors of AKI in patients with urinary system diseases.Spearman correlation analysis was used to analyze the correlation between urinary NGAL,L-FABP and Scr in AKI group.ROC curve was used to evaluate the diagnostic value of urinary NGAL and L-FABP levels for AKI.Results:The APACHE Ⅱ score,urinary L-FABP,and serum Scr and BUN levels in the AKI group were higher than those in the non-AKI group,and the urinary NGAL and serum Scr and BUN levels in the AKI group were lower than those in the non-AKI group(all P<0.05).Logistic regression analysis showed that eGFR,serum Scr,BUN,and urine NGAL,L-FABP levels were independent risk factors for AKI in patients with urinary system diseases(all P<0.05).The levels of NGAL and L-FABP in urine were positively correlated with Scr(r=0.609,0.817,both P<0.001).The combined detection of urinary NGAL and L-FABP was superior to the single detection in the diagnosis of AKI in patients with urinary system diseases.The area under the curve of urinary NGAL in the diagnosis of AKI was 0.803,the sensitivity was 79.17%,and the specificity was 70.83%; the area under the urine L-FABP curve was 0.817,with a sensitivity of 81.25% and specificity of 66.67%; the area under the combined detection curve was 0.887,with a sensitivity of 87.50% and specificity of 77.08%(P<0.001).Conclusion:The levels of L-FABP and NGAL in urine of AKI patients caused by urinary system diseases increase.The combined detection of urinary NGAL and L-FABP is more conducive to the diagnosis of AKI.

参考文献/References:

[1] To S,Goto H,Tanoue K,et al.Early treatment with C-reactive protein-derived peptide reduces septic acute kidney injury in mice via controlled activation of kidney macrophages[J].J Leukoc Biol,2023,113(4):400-413.
[2] 范 阳,刘展会,豆涛涛,等.冷诱导RNA结合蛋白在体外循环期间导致急性肾损伤机制实验研究[J].陕西医学杂志,2022,51(8):929-933.
[3] 董学广,傅晓夏,陈秀美,等.解毒通腑泻浊汤保留灌肠对脓毒症合并急性肾损伤患者微循环及血清炎性应激指标的影响[J].陕西中医,2022,43(10):1388-1391.
[4] 史小琴,钱 瑶.连续性肾脏替代治疗联合中药灌肠对急性肾损伤患者尿KIM-1、NGAL水平的影响[J].陕西中医,2020,41(2):210-212,216.
[5] Erben Y,Marquez CP,Prudencio M,et al.Race affects adverse outcomes of deep vein thrombosis,pulmonary embolism,and acute kidney injury in coronavirus disease 2019 hospitalized patients[J].J Vasc Surg Venous Lymphat Disord,2023,11(1):19-24.
[6] Piccuirro SR,Casapao AM,Claudio AM.Comparison of acute kidney injury in patients prescribed vancomycin in combination with piperacillin-tazobactam or cefepime for diabetic foot infections[J].J Investig Med,2021,69(8):1488.
[7] 陈雨意,田鹏超,吴易航,等.即时检验检测的中性粒细胞明胶酶相关脂质运载蛋白相关影响因素及其对心力衰竭预后的预测价值[J].中国循环杂志,2022,37(9):895-901.
[8] 沈 根,周芳芳,叶红华,等.尿肝型脂肪酸结合蛋白和高龄患者经皮冠状动脉介入术后肾功能损伤的相关性[J].中国病理生理杂志,2016,32(11):2031-2035.
[9] 黄乔木,何 艳.尿视黄醇结合蛋白、尿肝型脂肪酸结合蛋白、血成纤维细胞生长因子-21、血转化生长因子-β联合诊断早期糖尿病肾病的价值[J].临床肾脏病杂志,2022,22(4):283-290.
[10] Kosaki K,Sugaya T,Ohata K,et al.Renoprotective effects of voluntary running exercise training on aldosterone-induced renal injury in human L-FABP chromosomal transgenic mice[J].Hypertens Res,2019,42(10):1518-1527.
[11] Khwaj A.KDIGO clinical practice guidelines for acute kidney injury[J].Nephron,2012,120(4):179-184.
[12] 岳金凤,吴大玮,李 琛,等.以急性肾损伤网络标准评估重症监护病房患者急性肾损伤的发病率、预后及死亡相关危险因素[J].中华医学杂志,2011,56(4):260-264.
[13] Alobaidi R,Anton N,Burkholder S,et al.Association between acute kidney injury duration and outcomes in critically Ⅲ children[J].Pediatr Crit Care Med,2021,22(7):642-650.
[14] 孟 晨,赵 班,毛永辉.老年急性肾损伤患者的诊断标准选择及新型生物标志物的应用进展[J].中华老年医学杂志,2021,40(9):1194-1198.
[15] 潘俊娣,叶 斌,戴木根,等.肝硬化合并急性肾损伤患者尿NGAL、L-FABP变化及意义[J].中西医结合肝病杂志,2019,29(1):29-32,104.
[16] 杨小杰,李友芳,王 茜,等.肾康注射液联合还原型谷胱甘肽对梗阻性肾病患者肾功能、尿L-FABP、NGAL水平及预后的影响[J].疑难病杂志,2019,18(11):1113-1117.
[17] Dyga K,Machura E,Swietochowska E,et al.Analysis of the association between kidney injury biomarkers concentration and nephritis in immunoglobulin A vasculitis:A pediatric cohort study[J].Int J Rheum Dis,2020,23(9):1184-1193.
[18] Katayama M,Ohata K,Miyazaki T,et al.Renal expression and urinary excretion of liver-type fatty acid-binding protein in cats with renal disease[J].J Vet Intern Med,2020,34(2):761-769.
[19] 赵仁淹,郑瑞强.中性粒细胞明胶酶相关脂质运载蛋白对感染性休克继发急性肾损伤患者的早期诊断价值[J].临床急诊杂志,2018,19(7):443-446.
[20] 雷 蕾,李良平,张 虎.血清胱抑素C联合尿中性粒细胞明胶酶相关脂质运载蛋白对肝硬化腹水继发急性肾损伤的诊断价值[J].临床肝胆病杂志,2018,34(1):101-105.
[21] 徐 升,叶 佳,刘 洋,等.Ilizarov环形外固定架与Orthofix单边外固定架治疗胫骨大段骨缺损的疗效分析[J].中国现代医生,2023,61(9):35-38.
[22] 钟开义,黎宝仁,张祖文,等.尿KIM-1、NGAL及L-FABP在老年重症患者急性肾损伤早期诊断中的价值[J].临床急诊杂志,2018,19(12):850-854,858.
[23] 农贤刚,程卫萍.尿NGAL和L-FABP在儿童泌尿系统疾病致急性肾损伤诊断中的意义[J].中国中西医结合肾病杂志,2017,18(12):1080-1082.
[24] 汪 洁,陶龙芳,彭 康.尿L-FABP、NGAL联合ACR检测诊断妊娠期糖尿病早期肾功能损伤价值[J].中国计划生育学杂志,2022,30(6):1323-1326.
[25] 薛 庆,王 佳,倪建鑫,等.尿NGAL联合L-FABP水平对脓毒症急性肾损伤早期的诊断价值[J].中国医师杂志,2018,20(4):565-568.

备注/Memo

备注/Memo:
基金项目:山东省自然科学基金资助项目(ZR201702220392); 滨州医学院烟台附属医院教学改革与研究项目(2019JGKTY01)
更新日期/Last Update: 2023-11-06