sTREM-1和NGAL对脓毒血症并发急性肾损伤早期诊断的价值

目的探讨可溶性髓样细胞触发受体-1(s TREM-1)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对脓毒血症并发急性肾损伤(AKI)早期诊断的价值。方法选择脓毒血症患者共148例,其中发生AKI者46例,未发生AKI者共102例,分别归入AKI组非AKI组。收集两组的基本资料,在两组患者脓毒血症确诊后0 h、4 h、8 h、12 h、24h、48 h测定血肌酐(Scr)、尿s TREM-1和尿NGAL的水平并分析。结果 AKI组的Scr水平在脓毒血症12 h后开始较非AKI组显著升高,尿s TREM-1和尿NGAL均在8 h后开始出现显著升高,其脓毒血症后8 h、12 h、24 h、48 h均显著高于非AKI组。采用尿s TREM-1和尿NGAL联合对脓毒血症并发AKI进行早期诊断,敏感度为86.96%,特异度为76.47%,ROC曲线下面积为0.84。结论尿s TREM-1和尿NGAL是脓毒血症后AKI早期诊断的新型生物标志物。

sTREM-1 and NGAL levels for the early diagnosis of sepsis complicated by acute kidney injury

Objective To investigate soluble triggering receptor expressed on myeloid cells- 1（ s TREM- 1） and neutrophil gelatinase-associated lipocalin（ NGAL） levels for the early diagnosis of sepsis complicated by acute kidney injury（ AKI）. Methods A total of 148 patients with sepsis were collected,in which 46 cases occurred AKI and 102 cases did not occur. They were classified as AKI group and non- AKI group respectively. Basic data collection was taken in both groups. At 0 h,4 h,8 h,12 h,24 h and 48 h after diagnosis of sepsis,serum creatinine（ Scr）,urine NGAL and s TREM- 1 levels were measured and analyzed. Results Scr level increased in AKI group after 12 h,which was significantly higher than non- AKI group. Urine s TREM- 1 and NGAL were significantly increased after 8 h,which were significantly higher than non- AKI group at 8 h,12 h,24 h and 48 h. The sensitivity and specificity of combined detection of urine s TREM- 1 and NGAL were respectively86. 96% and 76. 47% for the diagnosis of AKI after sepsis,the area under the ROC curve was 0. 84. Conclusion Urine s TREM- 1 and NGAL are novel biomarkers for early diagnosis of AKI after sepsis.