摘要
目的探讨血清β2微球蛋白(β2-MG)、胱抑素C(CysC)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合检测在原发性肾病综合征(PNS)所致急性肾损伤(AKI)早期诊断价值。方法选取2019年6月至2022年6月衡水市人民医院肾内科收治的196例PNS患者作为研究对象,按照入院内72 h是否发生急性AKI将患者分为发生组(n=63)和未发生组(n=133)。比较两组患者的血清β2-MG、Cys-C、NGAL水平,采用单因素分析PNS所致AKI的影响因素。采用多因素Logisstic回归分析PNS所致AKI的独立影响因素,并采用受试者工作特征曲线(ROC)分析联合检测血清β2-MG、Cys-C、NGAL对PNS所致AKI的诊断效能。结果发生组的血清β2-MG、Cys-C、NGAL水平均明显高于未发生组,差异有统计学意义(t=32.066、14.636、20.474,P<0.05)。单因素分析结果显示,感染、抗生素药物、激素类药物以及免疫抑制剂为PNS所致AKI的影响因素(χ^(2)=11.589、5.737、26.606、38.775,P<0.05)。多因素Logistic回归分析显示,感染、激素类药物、血清β2-MG、Cys-C、NGAL均为PNS所致AKI的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清β2-MG、Cys-C、NGAL单独以及联合检测早期诊断PNS所致AKI的曲线下面积(AUC)分别0.809、0.795、0.756、0.912。结论血清β2-MG、Cys-C、NGAL均于PNS所致AKI的发生密切相关,联合检测在PNS所致AKI早期诊断价值,可为临床诊断提供参考数据。
Objective To investigate the combined detection value of serumβ2 microglobulin(β2⁃mg),cystatin C(CysC)and neutrophil gelatinase⁃associated lipid carrier protein(NGAL)in the early diagno⁃sis of acute kidney injury(AKI)caused by primary nephrotic syndrome(PNS).Methods A total of 196 pa⁃tients with PNS admitted to the Department of Nephrology of Hengshui People's Hospital from June 2019 to June 2022 were selected as the research objects.According to the occurrence of AKI,the patients were divided into the occurrence group(n=63)and the non⁃occurrence group(n=133).Serum levels ofβ2⁃MG,Cys⁃C and NGAL were compared between the two groups,and the influencing factors of PNS⁃induced AKI were analyzed by univariate analysis.Multivariate Logisstic regression was used to analyze the independent influencing factors of PNS⁃induced AKI,and the receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of combined serum beta2⁃mg,Cys⁃C and NGAL on PNS⁃induced AKI.Results The levels of serumβ2⁃MG,Cys⁃C and NGAL in the occurrence group were significantly higher than those in the non⁃occurrence group,with statistical significance(t=32.066,14.636,20.474,P<0.05).Univariate analysis showed that infec⁃tion,antibiotic drugs,hormone drugs and immunosuppressants were the influencing factors of PNs⁃induced AKI(χ^(2)=11.589,5.737,26.606,38.775,P<0.05).Multivariate Logistic regression analysis showed that infec⁃tion,hormone drugs,serumβ2⁃MG,Cys⁃C and NGAL were independent risk factors for PNS⁃induced AKI(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of serumβ2⁃MG,Cys⁃C and NGAL alone and combined in the early diagnosis of PNS⁃induced AKI were 0.809,0.795,0.756 and 0.912,respectively.Conclusion Serumβ2⁃MG,Cys⁃C and NGAL are closely related to the occurrence of PNS⁃induced AKI.Combined detection is valuable in the early diagnosis of PNS⁃induced AKI,and can provide reference data for clinical diagnosis.
作者
赵沛
赵黎
苑玉聪
ZHAO Pei;ZHAO Li;YUAN Yucong(Department of Nephrology,Hengshui People's Hospital,Hengshui,Hebei,China,053000;Hengshui People's Hospital,Hengshui,Hebei,China,053000)
出处
《分子诊断与治疗杂志》
2023年第6期1025-1029,共5页
Journal of Molecular Diagnostics and Therapy
基金
河北省医学科学研究重点课题计划(20181583)。
