Department of Emergency Medicine, Liqun Hospital, Putuo District, Shanghai, China.
Department of Nephrology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Acta Biochim Pol. 2022 Feb 28;69(1):113-117. doi: 10.18388/abp.2020_5755.
Sepsis is a host response with life-threatening organ dysfunction caused by an infection. Although the overall mortality rate has increased from 30% to 37% by the surviving sepsis campaign, it is still not acceptable. Early identification, accurate stratification and appropriate intervention can improve the prognosis. In this study we assessed the risk stratification and prognostic value of serum neutrophil gelatinase-associated lipocalin (sNGAL) as a biomarker in sepsis patients.
A total of 112 sepsis patients (38 patients with sepsis, 41 patients with severe sepsis, 33 patients with septic shock) and 25 healthy controls were enrolled in this study. Serum samples of all patients were collected and frozen before testing. Basic patient information was collected, including age, gender, primary infection, complications, and so on. Results of serum calcitonin, lactic acid, and SOFA score were followed up for 28 days.
Levels of serum procalcitonin (PCT), serum lactate, Sequential Organ Failure Assessment (SOFA) score and sNGAL of sepsis patients were significantly higher (p<0.05) than those of controls. The sNGAL level in sepsis patients who were alive on the 28th day of follow-up was significantly lower (p<0.05) than that of sepsis patients who had died before the 28th day of follow-up. Multiple logistic regression analysis showed that sNGAL-0h and lactates were independent risk factors of death due to sepsis within 28 days. At cut-off value of 250 ng/mL, the sensitivity and specificity sNGAL-0h predicting the 28-day mortality in septic patients were 0.838 and 0.827, respectively. The sNGAL level in sepsis patients with acute kidney injury (AKI) was significantly higher (p<0.05) than in sepsis patients without AKI.
Serum NGAL may contribute to the assessment of the severity of sepsis. Serum NGAL and lactate can be independent risk factors for 28-day mortality in sepsis patients. Serum NGAL has potential of predicting septic-AKI.
脓毒症是一种宿主反应，由感染引起危及生命的器官功能障碍。尽管通过存活脓毒症运动，总体死亡率从 30%增加到 37%，但仍不可接受。早期识别、准确分层和适当干预可以改善预后。在这项研究中，我们评估了血清中性粒细胞明胶酶相关脂质运载蛋白（sNGAL）作为脓毒症患者生物标志物的风险分层和预后价值。
共纳入 112 例脓毒症患者（38 例脓毒症、41 例严重脓毒症、33 例感染性休克）和 25 例健康对照者。所有患者在检测前采集血清样本并冷冻。收集患者的基本信息，包括年龄、性别、原发感染、并发症等。检测血清降钙素原、乳酸和 SOFA 评分，并随访 28 天。
脓毒症患者血清降钙素原（PCT）、乳酸、序贯器官衰竭评估（SOFA）评分和 sNGAL 水平明显高于对照组（p<0.05）。随访 28 天存活的脓毒症患者 sNGAL 水平明显低于随访 28 天内死亡的脓毒症患者（p<0.05）。多因素逻辑回归分析显示，sNGAL-0h 和乳酸是脓毒症患者 28 天内死亡的独立危险因素。在 250ng/ml 的截断值下，sNGAL-0h 预测脓毒症患者 28 天死亡率的敏感性和特异性分别为 0.838 和 0.827。急性肾损伤（AKI）脓毒症患者 sNGAL 水平明显高于无 AKI 患者（p<0.05）。
血清 NGAL 可能有助于评估脓毒症的严重程度。血清 NGAL 和乳酸可作为脓毒症患者 28 天死亡率的独立危险因素。血清 NGAL 对预测脓毒症-AKI 有一定的价值。
