Sarafidis Kosmas, Tsepkentzi Eleni, Diamanti Elisavet, Agakidou Eleni, Taparkou Anna, Soubasi Vasiliki, Papachristou Fotios, Drossou Vasiliki
Pediatr Nephrol. 2014 Feb;29(2):305-10. doi: 10.1007/s00467-013-2613-6.
The efficacy of urine neutrophil gelatinase-associated lipocalin (uNGAL) as an early acute kidney injury (AKI) biomarker in preterm neonates was evaluated.
Thirty-five preterm neonates were prospectively evaluated for serum creatinine (sCre)-documented AKI during the first 14 days of life. Urine samples were collected daily throughout the study period. Of the neonates evaluated, we analyzed 11 who developed AKI (cases) and an equal number of neonates without AKI (controls) matched for gestational and postnatal age (case-control study). uNGAL was measured on the day of AKI occurrence (day 0) and on the 2 days preceding the event (day -1 and day -2, respectively) using an enzyme-linked immunosorbent assay.
Cases had significantly higher sCre levels than controls on day 0 (1.21 ± 0.48 vs. 0.83 ± 0.16 mg/dL, p =0.031) but not on days -1 and -2. Similarly, uNGAL levels (ng/mL) were significantly higher in cases than in controls only on day 0 (19.1 ± 3.5 vs. 13.3 ± 7.3, p=0.017) and not on days -1 (18.8 ± 3.4 vs. 16.3 ± 5.9, p=0.118) and -2 (19.3 ± 1.8 vs. 19.4 ± 0.8, p =0.979). The receiver operating characteristic curve analysis showed no significant ability of uNGAL to predict AKI on days -2 and -1.
In this pilot study in preterm neonates, although uNGAL detected sCre-based AKI upon its documentation, it failed to predict its development 1-2 days earlier.
评估尿中性粒细胞明胶酶相关脂质运载蛋白（uNGAL）作为早产儿早期急性肾损伤（AKI）生物标志物的有效性。
对35例早产儿在出生后14天内进行前瞻性评估，以血清肌酐（sCre）记录AKI情况。在整个研究期间每天收集尿液样本。在评估的新生儿中，我们分析了11例发生AKI的新生儿（病例组）和数量相等的未发生AKI的新生儿（对照组），两组在胎龄和出生后年龄上相匹配（病例对照研究）。使用酶联免疫吸附测定法在AKI发生当天（第0天）以及事件发生前2天（分别为第 -1天和第 -2天）测量uNGAL。
病例组在第0天的sCre水平显著高于对照组（1.21±0.48 vs. 0.83±0.16 mg/dL，p = 0.031），但在第 -1天和第 -2天无显著差异。同样，uNGAL水平（ng/mL）仅在第0天病例组显著高于对照组（19.1±3.5 vs. 13.3±7.3，p = 0.017），而在第 -1天（18.8±3.4 vs. 16.3±5.9，p = 0.118）和第 -2天（19.3±1.8 vs. 19.4±0.8，p = 0.979）无显著差异。受试者工作特征曲线分析显示，uNGAL在第 -2天和第 -1天预测AKI的能力无显著意义。
在这项针对早产儿的初步研究中，尽管uNGAL在基于sCre记录到AKI时能够检测到，但未能提前1 - 2天预测其发生。
