| 陈红梅,陈 娇,李艳红,柏振江,黄林林.血清中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C联合红细胞分布宽度对脓毒症患儿急性肾损伤的预测价值[J].,2021,(23):4564-4568 |
| 血清中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C联合红细胞分布宽度对脓毒症患儿急性肾损伤的预测价值 |
| Predictive Value of Serum Neutrophil Gelatase-Associated Lipid Carrier Protein and Cystatin C Combined with Red Cell Distribution width in Children with Sepsis with Acute Kidney Injury |
| 投稿时间：2021-04-06 修订日期：2021-04-27 |
| DOI：10.13241/j.cnki.pmb.2021.23.035 |
| 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 胱抑素C 红细胞分布宽度 |
| 英文关键词: Sepsis Acute kidney injury Neutrophil gelatase-associated lipid carrier proteins Cystatin C Red cell distribution width |
| 基金项目:江苏省重点科技社会发展项目（BE2017657）；苏州市科技发展计划基金资助项目（SYS201760） |
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| 中文摘要: |
| 摘要 目的：研究血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、胱抑素C联合红细胞分布宽度（RDW）对脓毒症患儿急性肾损伤（AKI）的预测价值。方法：选取我院从2016年1月～2019年1月收治的脓毒症患儿154例。将所有患儿根据是否合并AKI分为AKI组67例和非AKI组87例。分析两组临床资料的差异，检测并比较血清NGAL、胱抑素C以及RDW水平。采用多因素Logistic回归分析脓毒症患儿发生AKI的影响因素。采用受试者工作特征（ROC）曲线分析血清NGAL、胱抑素C以及RDW预测脓毒症患儿AKI的效能。结果：AKI组与非AKI组在年龄、小儿危重病例评分（PCIS）、儿童重症监护室（PICU）停留时间、第三代小儿死亡危险评分(PRISM-Ⅲ)、肌酐（Cr）方面比较差异均有统计学意义（P＜0.05）。AKI组血清NGAL、胱抑素C以及RDW水平均高于非AKI组（P＜0.05）。经多因素Logistic回归分析发现：脓毒症患儿发生AKI的危险因素有PICU停留时间≥15 d、PRISM-Ⅲ＞32分、Cr＞100 μmol/L、血清NGAL＞220 ng/mL、血清胱抑素C＞1.55 mg/L以及RDW＞14%（均OR＞1，P＜0.05）；而防止脓毒症患儿发生AKI的保护因素包括年龄＞50月、PCIS＞70分（均OR＜1，P＜0.05）。经ROC曲线分析发现：血清NGAL、胱抑素C以及RDW联合检测预测脓毒症患儿AKI的曲线下面积、灵敏度、特异度以及约登指数均高于上述三项指标单独检测。结论：脓毒症合并AKI的患儿血清NGAL、胱抑素C以及RDW水平异常升高，且联合检测以上指标对脓毒症患儿AKI的预测价值较高，具有一定临床应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To study the predictive value of serum neutrophil gelatase-associated lipid carrier protein (NGAL), cystatin C combined with red cell distribution width (RDW) in children with sepsis with acute kidney injury (AKI). Methods: 154 cases of children with sepsis in our hospital from January 2016 to January 2019 were selected. All the children were divided into AKI group with 67 cases and non-AKI group with 87 cases according to whether they had AKI. The differences of general data between the two groups were analyzed, and the levels of serum NGAL, cystatin C and RDW were detected and compared. Multivariate Logistic regression analysis was used to analyze the influencing factors of children with sepsis with AKI. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of serum NGAL, cystatin C and RDW in predicting in children with sepsis with AKI. Results: There were statistically significant differences between AKI group and non-AKI group in terms of age, pediatric critical illness score (PCIS), pediatric intensive care unit (PICU) residence time, and third-generation child death risk score (PRISM-Ⅲ), creatinine(Cr) (P<0.05). The levels of serum NGAL, cystatin C and RDW in AKI group were all higher than those in non-AKI group (P<0.05). Multivariate Logistic regression analysis found that: the risk factors for children with sepsis with AKI were PICU residence time ≥15 d, PRISM-Ⅲ > 32 scores, Cr > 100 μmol/L, serum NGAL > 220 ng/mL, serum cystatin C > 1.55 mg/L and RDW > 14% (all OR > 1, P<0.05). The protective factors against children with sepsis with AKI included age > 50 months and PCIS > 70 scores (all OR < 1, P<0.05). The ROC curve analysis showed that the area under the curve, sensitivity, specificity and Youden index of serum NGAL, cystatin C and RDW combined test for predicting children with sepsis with AKI were higher than those of the above three indexes alone(P<0.05). Conclusion: Serum NGAL, cystatin C and RDW are abnormally elevated in children with sepsis with AKI, and combined detection of the above indexes has a high predictive value for children with sepsis with AKI, and which has certain clinical application value. |
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