NGAL 在危重症患者中的预后作用。

Prognostic Role of Ngal in Critically Ill Patients.

机构信息

MLN Medical College, Prayagraj.

出版信息

J Assoc Physicians India. 2022 Apr;70(4):11-12.

Abstract

UNLABELLED

Acute kidney injury (AKI) is a frequently encountered outcome in critically ill patients, accounting for increased mortality. Neutrophil gelatinase associated lipocalin (NGAL) has been of paramount importance as a novel biomarker of AKI. This study is an attempt to assess the use of NGAL in critically ill patients so that timely interventions can be done to reduce morbidity and mortality in such patients.

MATERIAL

A prospective observational study was conducted at SRN Hospital, Prayagraj from August 1st 2020 to March 15th 2021, which included only critically ill patients with SOFA score>1 and requiring ICU admission. Patients of known renal diseases were excluded from the study. Blood as well as urinary samples for NGAL and other laboratory parameters were collected within 8 hours of admission. Patients who developed renal dysfunction were noted as our cases and the others were noted as controls.

OBSERVATION

The study was done on 125 patients, out of which 67 developed AKI while 58 did not develop AKI. Higher mortality was seen in patients with higher stage of AKI (P- 0.011). The cutoff of serum and urinary NGAL for predicting AKI were >42.3 ng/mL, >40.5 ng/mL respectively (P value <0.001). Hazard Ratio for all cause mortality of raised serum and urinary NGAL was 2.0062 (p value- 0.0001, 95% CI-1.0031 to 1.0092) and 2.0046 (p value-0.0035, 95% CI-1.0015 to 1.0078) respectively. Serum and urinary neutrophil gelatinase associated lipocalin at values >91 and >131 respectively were found to predict requirement of hemodialysis (p value<0.001).

CONCLUSION

A single measurement of NGAL at the time of admission had good predictive ability for AKI. Higher values of NGAL were associated with staging of AKI and thus, correlated with need of hemodialysis. Furthermore, mortality was found to be associated with development of AKI and raised NGAL. Thus, NGAL maybe used to assess the prognosis of ICU patients so that patients at high risk may be managed aggressively, thus reducing mortality.

摘要

未加说明

急性肾损伤（AKI）是危重病患者中经常出现的一种结果，可导致死亡率增加。中性粒细胞明胶酶相关脂质运载蛋白（NGAL）作为 AKI 的新型生物标志物具有至关重要的意义。本研究旨在评估 NGAL 在危重病患者中的应用，以便及时进行干预，降低此类患者的发病率和死亡率。

材料

这是一项于 2020 年 8 月 1 日至 2021 年 3 月 15 日在 Prayagraj 的 SRN 医院进行的前瞻性观察性研究，仅纳入 SOFA 评分>1 并需要入住 ICU 的危重病患者。排除已知患有肾脏疾病的患者。在入院后 8 小时内采集血液和尿液样本以检测 NGAL 和其他实验室参数。发生肾功能障碍的患者被记录为病例，其余患者被记录为对照。

观察

本研究共纳入 125 例患者，其中 67 例发生 AKI，58 例未发生 AKI。AKI 分期较高的患者死亡率较高（P-0.011）。用于预测 AKI 的血清和尿液 NGAL 截断值分别为 >42.3ng/mL 和 >40.5ng/mL（P 值均<0.001）。升高的血清和尿液 NGAL 的全因死亡率的危险比分别为 2.0062（P 值为-0.0001，95%CI 为 1.0031 至 1.0092）和 2.0046（P 值为-0.0035，95%CI 为 1.0015 至 1.0078）。入院时血清和尿液中性粒细胞明胶酶相关脂质运载蛋白分别>91 和>131 时，预测需要血液透析（P 值均<0.001）。