摘要
目的探究肝型脂肪酸结合蛋白(L-FABP)与白介素18(IL-18)对于肝硬化失代偿期急性肾损伤(AKI)诊断的临床价值。方法选取医院治疗的肝硬化患者为观察对象,将符合AKI诊断的患者纳入观察组(n=30),选取年龄、性别以及疾病严重程度与观察组匹配的患者为对照组(n=30)。分析两组中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、IL-18、L-FABP、血肌酐(sCr)和血清胱抑素C(Cys C)水平,用ROC曲线分析5种生化指标对AKI诊断的特异性和敏感度。结果观察组患者的NGAL、L-FABP、IL-18、Cys-C和sCr水平均高于对照组,差异有统计学意义(P<0.05)。AKI血清学诊断指标sCr、L-FABP、IL-18在ROC曲线下面积分别为0.757(95%CI:0.564~0.913)、0.905(95%CI:0.822~0.985)、0.880(95%CI:0.723~0.947)。sCr最佳诊断点为74.79,敏感度为45%,特异性为95%;L-FABP最佳诊断点为9.68,敏感度为95%,特异性为75%;IL-18最佳诊断点为95.71,敏感度为85%,特异性为80%。结论与IL-18相比,L-FABP诊断肝硬化失代偿期AKI的价值最高,临床意义大,值得临床推广。
Objective To investigate the clinical value of hepatic fatty acid binding protein（ L-FABP） and interleukin 18（ IL-18） in the diagnosis of acute renal injury in decompensated cirrhosis patients. Methods The patients with liver cirrhosis treated were enrolled in the study. Patients who were diagnosed as AKI were enrolled in the observation group（ n = 30）,and the age,gender and severity of the disease matched the observation group as the control group（ n = 30）. The levels of eutrophil gelatinase-associated lipocalin（ NGAL）,IL-18,L-FABP,serum creatinine（ sCr） and serum cystatin C（ Cys C） in two groups were analyzed. The specificity and sensitivity of five biochemical indexes in the diagnosis of AKI was measured by ROC curve. Results The levels of NGAL,L-FABP,IL-18,Cys-C and sCr in the observation group were higher in the control group,the difference was statistical significance（ P〈 0. 05）. The areas under the ROC curve of AKI serological markers sCr,L-FABP and IL-18 were0. 757（95% CI：0. 564 ~ 0. 913）,0. 905（95% CI：0. 822 ~ 0. 985）,0. 880（95% CI：0. 723 ~ 0. 947）. Conclusion Compared with IL-18,L-FABP is of great clinical significance in the diagnosis of decompensated cirrhosis with AKI,worthy of clinical promotion.
作者
康晓征
赵勇
乐磊
李珍
郑微
任春梅
张宇
Kang Xiaozheng;Zhao Yong;Le Lei(Sichuan Academy of Medical Sciences,Sichuan Provincial People＇s Hospital,Chengdu 610100)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第8期1289-1293,共5页
Acta Universitatis Medicinalis Anhui
基金
四川省卫生和计划生育委员会科研课题(编号:150192)
关键词
急性肾损伤
肝型脂肪酸结合蛋白
白介素18
acute kidney injury
hepatic fatty acid binding protein
interleukin 18
