摘要
目的分析尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血降钙素原(PCT)联合全身免疫炎症指数(SII)三项指标在脓毒症继发急性肾损伤患者中的表达及临床意义。方法2019年5月至2022年10月四川大学华西医院资阳医院收治的124例患者,将继发急性肾损伤(AKI)患者纳入A组(n=48),未继发AKI患者纳入B组(n=76)。比较两组尿NGAL、血PCT水平,并根据血常规计算SII指数;根据AKI病情严重程度将A组患者分为Ⅰ、Ⅱ、Ⅲ期,比较不同分期患者的尿NGAL、血PCT、SII指数,分析以上指标与A组患者分期的相关性。分析尿NGAL、血PCT以及SII指数对早期预测脓毒症继发AKI的效能。结果A组尿NGAL、血PCT及SII指数值均明显高于B组(P<0.05);尿NGAL、血PCT及SII指数与A组AKI病情具有显著正相关(P<0.05);尿NGAL、血PCT及SII指数对脓毒症继发AKI患者的早期预测效果均较好,AUC值分别0.810、0.768、0.756,且三项指标联合预测时的AUC值、敏感度及特异度均优于单项检测时(P<0.05)。结论与单纯脓毒症患者相比,脓毒症继发AKI患者的尿NGAL、血PCT联合SII指数水平异常升高,三项指标联合检测对继发脓毒症具有一定的预测价值。
Objective To analyze the expression and clinical significance of urinary neutrophil gelatinase associated lipid transporter(NGAL),procalcitonin(PCT)and systemic immune inflammatory index(SII)in sepsis patients with acute renal injury.Methods One hundred and twenty-four patients admitted to Ziyang Hospital of West China Hospital of Sichuan University from May 2019 to October 2022 were selected.Patients with secondary acute renal injury(AKI)were included in group A(n=48),and patients without secondary AKI were included in group B(n=76).The urine NGAL and blood PCT levels were compared between the two groups,and the SII index was calculated according to blood routine examination.According to the severity of AKI,patients in the group A were divided into Phase I,II,and III.The urinary NGAL,blood PCT,and SII indexes of patients in different stages were also compared.The correlation between the above indicators and the stage of patients in the group A was analyzed.The effectiveness of urine NGAL,blood PCT and SII index in early prediction of AKI secondary to sepsis was analyzed.Results The values of urine NGAL,blood PCT and SII in the group A were significantly higher than those in the group B(P<0.05).The urine NGAL,blood PCT and SII index were positively correlated with AKI in the group A(P<0.05).Urine NGAL,blood PCT and SII index had a good early prediction effect on sepsis patients with AKI,with AUC values of 0810,0768 and 0756,respectively.The AUC value,sensitivity and specificity of the combined prediction of the three indicators were better than those of single indicator(P<0.05).Conclusions Compared with patients with pure sepsis,urine NGAL,blood PCT and SII index levels of patients with AKI secondary to sepsis are ab-normally elevated.The combined detection of the three indicators has a certain predictive value for AKI secondary to sepsis.
作者
邓亮
郭碧君
邹燕群
谢婷
黄贵祥
DENG Liang;GUO Bi-jun;ZOU Yan-qun;XIE Ting;HUANG Gui-xiang(Department of Intensive Care Medicine,Ziyang Hospital,West China Hospital,Sichuan University,Ziyang 641300,China;Department of Emergency,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China)
出处
《实用医院临床杂志》
2023年第4期99-103,共5页
Practical Journal of Clinical Medicine
基金
四川省卫生和计划生育委员会科研基金资助项目(编号:20ZD003)。
