中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C及髓系细胞表面表达的可溶性触发受体-1对脓毒症相关急性肾损伤危重症患者的诊断价值
Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.
作者信息
Dai Xingui, Zeng Zhenhua, Fu Chunlai, Zhang Sheng'an, Cai Yeping, Chen Zhongqing
机构信息
Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong, 510515, China.
Department of Critical Care Medicine, the First People's Hospital of Chenzhou, Luo Jia Jin Street 108, Chenzhou, Hunan, 423000, China.
出版信息
Crit Care. 2015 May 6;19(1):223. doi: 10.1186/s13054-015-0941-6.
INTRODUCTION
Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis.
METHODS
We divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis.
RESULTS
Both plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P < 0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair.
CONCLUSION
Plasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.
引言
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、胱抑素C（Cys-C）和髓系细胞触发受体-1（sTREM-1）是急性肾损伤（AKI）的新型诊断生物标志物。我们旨在确定这些生物标志物在脓毒症重症患者中检测AKI的诊断特性。
方法
我们将112例脓毒症患者分为非AKI脓毒症组（n = 57）和AKI脓毒症组（n = 55）。入院时及之后每24小时直至72小时采集血浆和尿液样本，检测NGAL、Cys-C和TREM-1浓度。比较入院时、诊断时以及诊断前24小时的水平。
结果
即使在使用广义估计方程对混杂因素进行校正后，脓毒症患者血浆和尿液中的NGAL、Cys-C和sTREM-1均与AKI的发生显著相关。与非AKI脓毒症组相比，脓毒症AKI组在诊断时和AKI诊断前24小时这些生物标志物水平明显更高（P < 0.01）。血浆和尿液NGAL的诊断和预测价值良好，血浆和尿液Cys-C以及sTREM-1的诊断和预测价值中等。
结论
血浆和尿液中的NGAL、Cys-C和sTREM-1可作为脓毒症重症患者AKI的诊断和预测生物标志物。
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