| 郑 军,刘丽丽,韩晋宇,贾 萌,王娅丽,王 毅.脓毒症合并急性肾损伤患者尿液NGAL水平与肾动脉阻力指数、APACHEⅡ评分及28 d病死率的关系[J].,2021,(15):2897-2901 |
| 脓毒症合并急性肾损伤患者尿液NGAL水平与肾动脉阻力指数、APACHEⅡ评分及28 d病死率的关系 |
| Relationship between Urine NGAL Levels and Renal Artery Resistance Index, APACHE Ⅱ Score and 28 d Mortality in Patients with Sepsis Complicated with Acute Kidney Injury |
| 投稿时间：2020-12-28 修订日期：2021-01-23 |
| DOI：10.13241/j.cnki.pmb.2021.15.020 |
| 中文关键词: 脓毒症 急性肾损伤 中性粒细胞明胶酶相关脂质运载蛋白 肾动脉阻力指数 APACHEⅡ评分 28d病死率 |
| 英文关键词: Sepsis Acute kidney injury Neutrophil gelatinase-associated lipid carrier protein Renal artery resistance index APACHEⅡscore 28 d mortality |
| 基金项目:新疆维吾尔自治区自然科学基金项目(2017D01C102)；新疆医科大学第六临床医学院（第六附属医院）科研专项基金-自然科学基金项目(LFYKJ2020001) |
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| 中文摘要: |
| 摘要 目的：研究脓毒症合并急性肾损伤（AKI）患者尿液中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与肾动脉阻力指数（RRI）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及28 d病死率的关系。方法：选取2017年2月～2019年12月期间我院收治的脓毒症患者251例纳入研究，将其按照是否发生AKI分为AKI组116例和非AKI组135例。检测并比较两组尿液NGAL水平、RRI、APACHEⅡ评分。采用Pearson相关性分析尿液NGAL水平与RRI、APACHEⅡ评分的关系。此外，将AKI组患者按照随访28d时是否死亡分为死亡组32例和存活组84例，比较两组尿液NGAL水平、基线资料、序贯性器官功能衰竭（SOFA）评分以及实验室指标，通过多因素Logistic回归分析脓毒症合并AKI患者28 d死亡率与相关因素的关系。结果：AKI组尿液NGAL水平、RRI、APACHEⅡ评分均明显高于非AKI组（均P＜0.05）。经Pearson相关性分析表明：尿液NGAL水平与RRI、APACHEⅡ评分均呈正相关（均P＜0.05）。死亡组AKI分期2～3期人数占比高于存活组，且SOFA评分、APACHEⅡ评分以及尿液NGAL、尿肾损伤分子-1（Kim-1）水平均高于存活组，而尿胱抑素C（CysC）水平低于存活组（均P＜0.05）。经多因素Logistic回归分析发现：AKI分期2～3期、SOFA评分、APACHEⅡ评分、尿液NGAL以及尿Kim-1均是脓毒症合并AKI患者28 d死亡的危险因素，而尿CysC为其保护因素（均P＜0.05）。结论：尿液NGAL在脓毒症合并AKI患者中明显高表达，且和RRI、APACHEⅡ评分及28 d病死率密切相关。 |
| 英文摘要: |
| ABSTRACT Objective: To study the relationship between urine neutrophil gelatinase-associated lipid carrier protein (NGAL) levels and renal artery resistance index (RRI), Acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score and 28 d mortality in patients with sepsis complicated with acute kidney injury (AKI). Methods: 251 patients with sepsis admitted to our hospital from February 2017 to December 2019 were included in the study, and divided into 116 patients in the AKI group and 135 patients in the non AKI group according to whether AKI had occurred. The two groups of urine NGAL levels, RRI, APACHE Ⅱscore were tested and compared. Pearson correlation analysis was used to analyze the relationship between urine NGAL level and RRI, APACHE II score In addition, patients in the AKI group were divided into the death group with 32 cases and the survival group with 84 cases according to whether they died at 28 d follow-up. Urine NGAL levels, baseline data and sequential organ failure (SOFA) scores and laboratory indicators were compared between the two groups, and the relationship between 28 d mortality and related factors in patients with sepsis complicated with AKI was analyzed by multivariate Logistic regression. Results: The urine NGAL level, RRI, APACHEⅡscore in AKI group were significantly higher than those in non AKI group (all P<0.05). The Pearson correlation analysis showed that urine NGAL levels and RRI, APACHEⅡscores were positively correlated(all P<0.05). The proportion of patients with AKI stage 2～3 in death group was higher than that in survival group, and SOFA score, APACHEⅡscore, urine NGAL and urinary kidney injury molecule - 1 (Kim-1) levels were higher than those in survival group, and urinary bladder inhibition C(CysC) level was lower than that in survival group(all P<0.05). Multivariate Logistic regression analysis showed that AKI stage 2～3, SOFA score, APACHE II score, urine NGAL and urine Kim-1 were the risk factors of 28 d death in patients with sepsis complicated with AKI, while urinary CysC was the protective factor (all P<0.05). Conclusion: Urine NGAL is highly expressed in patients with sepsis complicated with AKI, and it is closely related to RRI, APACHEⅡ score and 28d mortality. |
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