ICU患者中使用尿中性粒细胞明胶酶相关脂质运载蛋白和多普勒超声评估肾功能：一项为期1年的观察性初步研究。
Evaluation of Renal Function with Urinary NGAL and Doppler Ultrasonography in ICU Patients: A 1-Year Observational Pilot Study.
作者信息
Brogi Etrusca, Rago Rocco, Forfori Francesco
机构信息
Department of Anaesthesia and Intensive Care, University of Pisa, 56126 Pisa, Italy.
出版信息
Pathophysiology. 2024 Apr 3;31(2):190-196. doi: 10.3390/pathophysiology31020015.
BACKGROUND
We estimated the diagnostic accuracy of urinary NGAL for the diagnosis of AKI.
METHODS
Urinary NGAL and Creatinine were measured daily for up to 3 days. Doppler ultrasonography was performed within 24 h of admission and for the following 3 days.
RESULTS
Of the 21 patients, 44% had AKI during their ICU stay. The AKI group presented with higher values of serum Creatinine, renal length, MDRD as well as SAPS II already at admission. Urinary NGAL was significantly higher among patients with AKI and patients AKI-no at T0 ( < 0.0001) and increased steadily on T1 and T2. Urinary NGAL seemed to be a notable diagnostic marker for AKI from the first measurement (T0) with an area under the ROC of 0.93 (95% CI = 0.78-0.99) with a sensitivity of 99%. RRI levels were slightly higher in the AKI group at each time and increased gradually from T0 to T2 but reached statistical significance only at T2 ( = 0.02). Renal length and SAPS II at T0 showed high AuRoc and sensitivity.
CONCLUSIONS
Urinary NGAL is a valuable marker for AKI in intensive care settings. It seemed that a pre-existing chronic renal disease, the SAPS II and the NGAL at admission represented the principal predictors of AKI.
背景
我们评估了尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）对急性肾损伤（AKI）的诊断准确性。
方法
连续3天每天测量尿NGAL和肌酐。入院后24小时内及随后3天进行多普勒超声检查。
结果
21例患者中，44%在重症监护病房（ICU）住院期间发生AKI。AKI组在入院时血清肌酐、肾长度、肾脏病饮食改良（MDRD）公式估算的肾小球滤过率以及简化急性生理学评分（SAPS）II值就较高。AKI患者和非AKI患者在T0时尿NGAL显著更高（P<0.0001），并在T1和T2时稳步升高。从首次测量（T0）起，尿NGAL似乎就是AKI的一个显著诊断标志物，ROC曲线下面积为0.93（95%CI=0.78-0.99），敏感性为99%。AKI组在各时间点的肾阻力指数（RRI）水平略高，从T0到T2逐渐升高，但仅在T2时达到统计学显著性（P=0.02）。T0时的肾长度和SAPS II显示出较高的受试者工作特征曲线下面积（AuRoc）和敏感性。
结论
在重症监护环境中，尿NGAL是AKI的一个有价值的标志物。似乎既往存在的慢性肾病、SAPS II以及入院时的NGAL是AKI的主要预测因素。
Zotero 插件