Altern Ther Health Med. 2022 Oct;28(7):120-124.
The aim of this study was to evaluate the predictive value of urinary neutrophil gelatinase-associated lipid (uNGAL) for the prediction of sepsis-associated acute kidney injury (SA-AKI).
From September to December 2012, 110 patients were prospectively enrolled from the intensive care units (ICUs) of 3 general hospitals. After being admitted to the ICU, the patients were continuously observed for 72 hours. According to the Kidney Disease Improving Global Outcomes (KDIGO) criteria for the diagnosis of acute kidney injury (AKI), the patients were divided into the AKI group (33 patients) and non-AKI group (77 patients). Per the sepsis diagnostic criteria, the patients were classified as septic (79 patients) and non-septic (31 patients). Serum creatinine and uNGAL of the patients were analyzed daily. The difference in uNGAL in septic and non-septic patients, patients with and without AKI, and septic patients with with and without AKI were compared. In addition, the difference in serum creatinine and uNGAL in patients with and without AKI were recorded and compared, and the sensitivity and specificity of uNGAL and sCr for the diagnosis of AKI in the ICU patients were evaluated using the receiver operating characteristic (ROC) curve.
uNGAL levels were all significantly different in septic and non-septic patients (P = .001, P = .028, P = .010, respectively), patients with and without AKI (P = .001, P = .042, P = .001, respectively), septic patients with AKI and septic patients without AKI (P = .003, P = .012, P = .001, respectively) at 24, 48 and 72 hours after being admitted to the ICU, while the difference in sCr was not significant (P = .169) after 24 hours. The area under the ROC curve of uNGAL and sCr in patients admitted to the ICU at 24 hours were 0.828 (95% CI, 0.742 to 0.914) and 0.583 (95% CI, 0.471 to 0.695), respectively. The cutoff value of uNGAL was 170 ng/mL in patients admitted to the ICU at 24 hours, and the sensitivity and specificity were 0.778 and 0.784, respectively. The sensitivity of uNGAL was superior sCr.
uNGAL has relatively high sensitivity and specificity in predicting the occurrence of AKI in septic patients, which is superior to sCr and has certain clinical early diagnostic value. uNGAL could be used as an indicator for early diagnosis of AKI in septic patients in the ICU.
本研究旨在评估尿中性粒细胞明胶酶相关脂质（uNGAL）对脓毒症相关性急性肾损伤（SA-AKI）预测的价值。
2012 年 9 月至 12 月，前瞻性纳入 3 家综合医院重症监护病房（ICU）的 110 名患者。入 ICU 后，连续观察 72 小时。根据肾脏病预后质量倡议（KDIGO）急性肾损伤（AKI）的诊断标准，将患者分为 AKI 组（33 例）和非 AKI 组（77 例）。根据脓毒症诊断标准，患者分为脓毒症（79 例）和非脓毒症（31 例）。每天分析患者的血清肌酐和 uNGAL。比较脓毒症和非脓毒症患者、AKI 患者和非 AKI 患者、脓毒症 AKI 患者和非 AKI 患者之间的 uNGAL 差异。此外，记录并比较 AKI 患者和非 AKI 患者的血清肌酐和 uNGAL 差异，并使用受试者工作特征（ROC）曲线评估 uNGAL 和 sCr 对 ICU 患者 AKI 的诊断敏感性和特异性。
脓毒症和非脓毒症患者（P=0.001、P=0.028、P=0.010）、AKI 患者和非 AKI 患者（P=0.001、P=0.042、P=0.001）、脓毒症 AKI 患者和脓毒症非 AKI 患者（P=0.003、P=0.012、P=0.001）入院后 24、48 和 72 小时 uNGAL 水平均有显著差异，而 sCr 差异无统计学意义（P=0.169）。入院后 24 小时，uNGAL 和 sCr 在 ICU 患者中的 ROC 曲线下面积分别为 0.828（95%CI：0.742-0.914）和 0.583（95%CI：0.471-0.695）。入院后 24 小时，uNGAL 的截断值为 170ng/ml，敏感性和特异性分别为 0.778 和 0.784。uNGAL 的敏感性优于 sCr。
uNGAL 对预测脓毒症患者 AKI 的发生具有较高的敏感性和特异性，优于 sCr，具有一定的临床早期诊断价值。uNGAL 可作为 ICU 脓毒症患者 AKI 的早期诊断指标。
