肝硬化并发急性肾损伤患者血清NGAL、cys C及尿KIM-1的表达及其意义

doi:10.3969/j.issn.1671-7171.2022.08.031

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摘要【目的】探讨肝硬化并发急性肾损伤(AKI)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、半胱氨酸蛋白酶抑制剂C(cys C)及尿肾损伤因子1(KIM-1)水平及患者并发AKI的危险因素。【方法】 184例肝硬化患者依据其是否并发AKI分为AKI组(n=27)和非AKI组(n=157)。收集并比较两组患者基础资料及相关实验室指标检测水平[包括血红蛋白(Hb)、血清白蛋白(ALB)、白细胞(WBC)、血小板计数(PLT)、血清谷丙转氨酸(ALT)、谷草转氨酸(AST)、凝血酶原活动度(PTA)、NGAL、cys C、尿KIM-1]的差异,并通过受试者工作特征(ROC)曲线分析血清NGAL、cys C及尿KIM-1水平预测肝硬化患者并发AKI的价值,最后将两组有差异的信息纳入多因素Logistic回归分析,行量化赋值,明确肝硬化患者并发AKI的危险因素。【结果】两组年龄、性别、体重指数、是否合并高血压、是否有吸烟史、肝硬化分级、肝硬化病因、是否合并腹水及Hb、ALB、WBC、PLT、PTA、ALT、AST水平相比较,差异均无统计学意义(P>0.05)。AKI组合并糖尿病、感染的患者占比及血清NGAL、血清cys C、尿KIM-1水平均显著高于非AKI组(P<0.05)。经ROC分析证实,血清NGAL、cys C及尿KIM-1均能用于肝硬化患者并发AKI的预测,曲线下面积分别为0.854、0.835、0.834(均P<0.05)。多因素Logistic回归分析显示,糖尿病、感染、血清NGAL和cys C、尿KIM-1是肝硬化患者并发AKI的独立影响因素(P<0.05)。【结论】NGAL、cys C及尿KIM-1水平在肝硬化并发AKI患者中显著升高,可作为早期预测肝硬化并发AKI的敏感指标。

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	邓向海
	黄钰莹
	黄宁
	王涛

关键词 ：肝硬化/并发症, 急性肾损伤/并发症, 脂笼蛋白质2/血液, 抑素类/血液

Abstract：【Objective】To investigate the levels of serum neutrophil gelatinase associated lipid carrier protein (NGAL),cysteine protease inhibitor C (cys C) and urinary renal injury factor 1 (KIM-1) in patients with cirrhosis complicated with acute renal injury (AKI) and analyze the risk factors of AKI. 【Methods】A total of 184 patients with liver cirrhosis were divided into the AKI group (n=27) and the non AKI group (n=157) according to whether they were complicated with AKI. The difference between the two groups of patients' basic information and the detection level of relevant laboratory indicators [including hemoglobin (Hb),serum albumin (ALB),white blood cells (WBC),platelet count (PLT),serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),prothrombin activity (PTA),NGAL,cys C,and urinary KIM-1] were collected and compared. The serum NGAL cys C and urinary KIM-1 levels were used to predict the value of AKI in patients with liver cirrhosis. Finally,the different information between the two groups was included in the multivariate logistic regression analysis,and the quantitative assignment was performed to identify the risk factors of AKI in patients with liver cirrhosis. 【Results】There was no significant difference between the two groups in terms of age,sex,body mass index,hypertension,smoking history,classification of liver cirrhosis,etiology of liver cirrhosis,ascites,Hb,ALB,WBC,PLT,PTA,ALT and AST levels (P>0.05).The proportion of patients with AKI combined with diabetes and infection,and the levels of serum NGAL,serum cys C and urinary KIM-1 were significantly higher than those in non AKI group (P<0.05). ROC analysis showed that serum NGAL,cys C and urinary KIM-1 were used to predict AKI in patients with liver cirrhosis. The areas under the curve were 0.854,0.835 and 0.834,respectively,(all P<0.05). Multivariate logistic regression analysis showed that diabetes,infection,serum NGAL,cys C and urinary KIM-1 were independent influencing factors of AKI in patients with liver cirrhosis (P<0.05). 【Conclusion】Serum NGAL,cys C and urinary KIM-1 levels were significantly increased in patients with cirrhosis complicated with AKI,which can be used as sensitive indicators for early prediction of cirrhosis complicated with AKI.

Key words： Liver Cirrhosis/CO Acute Kidney Injury/CO Lipocalin-2/BL Chalones/BL

收稿日期: 2022-01-10

中图分类号:

R571.3

通讯作者: *E-mail:570307110@qq.com

引用本文:

邓向海, 黄钰莹, 黄宁, 王涛. 肝硬化并发急性肾损伤患者血清NGAL、cys C及尿KIM-1的表达及其意义[J]. 医学临床研究, 2022, 39(8): 1235-1238.
DENG Xiang-hai, HUANG Yu-ying, HUANG Ning, et al. Expression and Significance of Serum NGAL,cys C and Urinary KIM-1 in Patients with Liver Cirrhosis Complicated with Acute Renal Injury. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1235-1238.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.08.031 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I8/1235

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