Watanabe Mirian, Silva Gabriela Fulan E, Fonseca Cassiane Dezoti da, Vattimo Maria de Fatima Fernandes
Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ter Intensiva. 2014 Oct-Dec;26(4):347-54. doi: 10.5935/0103-507X.20140053.
To assess the diagnostic and prognostic efficacy of urine neutrophil gelatinase-associated lipocalin in patients admitted to an intensive care unit.
Longitudinal, prospective cohort study conducted in a cardiology intensive care unit. The participants were divided into groups with and without acute kidney injury and were followed from admission to the intensive care unit until hospital discharge or death. Serum creatinine, urine output and urine neutrophil gelatinase-associated lipocalin were measured 24 and 48 hours after admission.
A total of 83 patients admitted to the intensive care unit for clinical reasons were assessed, most being male (57.8%). The participants were divided into groups without acute kidney injury (N=18), with acute kidney injury (N=28) and with severe acute kidney injury (N=37). Chronic diseases, mechanical ventilation and renal replacement therapy were more common in the groups with acute kidney injury and severe acute kidney injury, and those groups exhibited longer intensive care unit stay and hospital stay and higher mortality. Serum creatinine did not change significantly in the group with acute kidney injury within the first 24 hours of admission to the intensive care unit, although, urine neutrophil gelatinase-associated lipocalin was high in the groups with acute kidney injury and severe acute kidney injury (p<0.001). Increased urine neutrophil gelatinase-associated lipocalin was associated with death.
An increase in urine neutrophil gelatinase-associated lipocalin precedes variations in serum creatinine in patients with acute kidney injury and may be associated with death.
评估尿中性粒细胞明胶酶相关脂质运载蛋白对入住重症监护病房患者的诊断和预后价值。
在心脏重症监护病房进行纵向、前瞻性队列研究。将参与者分为急性肾损伤组和非急性肾损伤组，从入住重症监护病房开始随访直至出院或死亡。入院后24小时和48小时测量血清肌酐、尿量及尿中性粒细胞明胶酶相关脂质运载蛋白。
共评估了83例因临床原因入住重症监护病房的患者，其中大多数为男性（57.8%）。参与者被分为非急性肾损伤组（N = 18）、急性肾损伤组（N = 28）和严重急性肾损伤组（N = 37）。急性肾损伤组和严重急性肾损伤组中慢性病、机械通气及肾脏替代治疗更为常见，且这些组的重症监护病房住院时间和住院时间更长，死亡率更高。在入住重症监护病房的最初24小时内，急性肾损伤组的血清肌酐无显著变化，尽管急性肾损伤组和严重急性肾损伤组的尿中性粒细胞明胶酶相关脂质运载蛋白水平较高（p < 0.001）。尿中性粒细胞明胶酶相关脂质运载蛋白升高与死亡相关。
急性肾损伤患者尿中性粒细胞明胶酶相关脂质运载蛋白升高先于血清肌酐变化，且可能与死亡相关。
