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- Title
NGAL 和 KIM-1 检测在儿童脓毒症合并急性 肾损伤中的诊断价值.
- Authors
徐佳音; 朱海燕; 徐 锦
- Abstract
Objective To investigate the clinical value of neutrophil gelatinase-associated lipocalin (NGAL)and kidney injury molecule 1(KIM-1)in cases of sepsis with acute kidney injury(AKI)during the diagnosis and treatment of pediatric patients. Methods A case-control study was performed among 82 children diagnosed with sepsis and admitted to the PICU of Children’s Hospital,Fudan University between Jan.and Dec.of 2019.Excluding 13 cases,they were divided into 28 cases of sepsis AKI group and 41 cases of sepsis non-AKI group according to the diagnosis of AKI after admission.According to whether continuous renal replacement therapy(CRRT)was performed during the treatment,children in the sepsis AKI group were further divided into sepsis AKI-CRRT group and sepsis AKI-non-CRRT group. Serum NGAL,KIM-1,cystatin C(CysC),retinol-binding protein(RBP)and creatinine in sepsis children with or without AKI were detected at the time points of 0 hour(0 h),24 hours(24 h)and 72 hours(72 h)after admission,respectively. Urine output were monitored at 24 h and 72 h. The levels of nonparametric test statistical method was employed to analyze the data. The diagnostic value of NGAL,KIM-1,creatinine, urine output,CysC and RBP in sepsis with AKI was analyzed by observing the receiver operating curve (ROC). Results In children of sepsis AKI group,the detection values of NGAL,KIM-1,creatinine and CysC at 0 h,24 h and 72 h were significantly higher than those in sepsis non-AKI group(P<0.05).The levels of NGAL and creatinine at each time point in sepsis AKI-CRRT group and non-CRRT group were higher than those in sepsis non-AKI group(P<0.05).Levels of KIM-1,CysC,RBP and urine output at 24 h and 72 h in sepsis AKI group was significantly different from those in sepsis non-AKI group(P<0.05). Comparison of ROC curves showed that the AUC area of NGAL at 0 h in sepsis AKI-CRRT group and non-CRRT group was the largest(0.907 and 0.951,respectively),and the sensitivity was the highest(92% and 100%,respectively).The creatinine level of sepsis AKI-CRRT group treatment decreased at 72 h,and the AUC area of creatinine at 72 h was lower than that at 24 h,and the sensitivity and specificity decreased (P<0.05). While NGAL and KIM-1 levels increased significantly at 24 h,then remained high at 72 h. NGAL at the 3 time points and KIM-1 at the last 2 time points maintained good diagnostic performance. Conclusion NGAL has high sensitivity and may act as an early indicator for occurrence of acute kidney injury. Due to their less interference during the treatment of blood purification,NGAL and KIM-1 may help to evaluate the true level of renal function in children with AKI.
- Publication
Fudan University Journal of Medical Sciences, 2021, Vol 48, Issue 1, p82
- ISSN
1672-8467
- Publication type
Article
- DOI
10.3969/j.issn.1672-8467.2021.01.013