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尿肾损伤分子-1（KIM-1）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）联合血清胱抑素 C 对预测肝硬化失代偿继发急性肾损伤的价值。

Value of urinary KIM-1 and NGAL combined with serum Cys C for predicting acute kidney injury secondary to decompensated cirrhosis.

机构信息

Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Sci Rep. 2018 May 21;8(1):7962. doi: 10.1038/s41598-018-26226-6.

DOI:10.1038/s41598-018-26226-6
PMID:29784944
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5962573/
Abstract

Urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and serum cystatin C (Cys C) are biomarkers of acute kidney injury (AKI). However, the efficacy of combining these indices to diagnose decompensated cirrhosis is unknown. This study involved 150 patients divided into AKI and non-AKI, and healthy individuals. Urinary KIM-1 and NGAL, serum Cys and creatine, and glomerular filtration rate (GFR) were compared based on Child-Pugh liver function class. Urinary KIM-1 and NGAL concentrations and serum Cys C levels were significantly higher in patients with AKI secondary to decompensated cirrhosis than in those with AKI not secondary to decompensated cirrhosis (p < 0.01). These were significantly associated with higher kidney injury index stages (p < 0.01) and negatively correlated with GFR in secondary AKI patients. Urinary KIM-1 and NGAL and serum Cys C increased significantly and GFR decreased as Child-Pugh class of decompensated cirrhosis significantly increased (p < 0.05). SCr levels were significantly increased in Child-Pugh class C patients (p < 0.05). Urinary KIM-1, urinary NGAL, serum Cys C, and the combined detection factor, as screening indices, could aid in the early diagnosis of AKI secondary to decompensated cirrhosis.

摘要

尿肾损伤分子-1（KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和血清胱抑素 C（Cys C）是急性肾损伤（AKI）的生物标志物。然而，将这些指标联合用于诊断失代偿性肝硬化的疗效尚不清楚。本研究纳入了 150 例患者，分为 AKI 组和非 AKI 组，以及健康对照组。根据 Child-Pugh 肝功能分级，比较了尿 KIM-1 和 NGAL、血清 Cys 和肌酸酐以及肾小球滤过率（GFR）。与非失代偿性肝硬化相关 AKI 患者相比，失代偿性肝硬化相关 AKI 患者的尿 KIM-1 和 NGAL 浓度及血清 Cys C 水平明显升高（p<0.01）。这些与更高的肾脏损伤指数阶段显著相关（p<0.01），并与继发性 AKI 患者的 GFR 呈负相关。随着失代偿性肝硬化 Child-Pugh 分级的显著增加，尿 KIM-1、NGAL 和血清 Cys C 显著增加，GFR 降低（p<0.05）。C 级患者的血清 Scr 水平明显升高（p<0.05）。尿 KIM-1、尿 NGAL、血清 Cys C 和联合检测因子作为筛查指标，可有助于早期诊断失代偿性肝硬化继发的 AKI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/a4c12afc1329/41598_2018_26226_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/8c7799d0c4ca/41598_2018_26226_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e02ce6e76a87/41598_2018_26226_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/5280ece4343d/41598_2018_26226_Fig3_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e0ff851e4b17/41598_2018_26226_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/885dc126ef78/41598_2018_26226_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e95e50cbda45/41598_2018_26226_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/a4c12afc1329/41598_2018_26226_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/8c7799d0c4ca/41598_2018_26226_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e02ce6e76a87/41598_2018_26226_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/5280ece4343d/41598_2018_26226_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/40df6283f321/41598_2018_26226_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e0ff851e4b17/41598_2018_26226_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/885dc126ef78/41598_2018_26226_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/e95e50cbda45/41598_2018_26226_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa84/5962573/a4c12afc1329/41598_2018_26226_Fig8_HTML.jpg

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