Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.
Diagnostic value of neutrophil gelatinase-associated lipocalin, cystatin C, and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury.
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DOI：
10.1186/s13054-015-0941-6
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发表时间：
2015-05-06
期刊：
影响因子：
--
通讯作者：
Chen Z
中科院分区：
文献类型：
--
作者：
Dai X;Zeng Z;Fu C;Zhang S;Cai Y;Chen Z
中性粒细胞明胶酶相关脂钙蛋白（NGAL）、胱抑素C （Cys-C）和可溶性髓细胞触发受体-1 （sTREM-1）是急性肾损伤（AKI）的新型诊断生物标志物。我们的目的是确定这些生物标志物在脓毒症危重患者中检测AKI的诊断特性。我们将112例脓毒症患者分为非AKI脓毒症组（n = 57）和AKI脓毒症组（n = 55）。入院时和72小时前每24小时采集一次血浆和尿液标本，检测NGAL、Cys-C和TREM-1浓度。在入院时、诊断时和诊断前24小时比较它们的水平。血浆和尿液NGAL、Cys-C和sTREM-1与脓毒症患者AKI的发展显著相关，即使在使用广义估计方程调整混杂因素后也是如此。与非AKI脓毒症组相比，脓毒症AKI组在诊断时和AKI诊断前24小时的这些生物标志物水平均显著升高（P <0.01）。血浆和尿液NGAL的诊断和预测价值较好，血浆和尿液Cys-C和sTREM-1的诊断和预测价值一般。血浆和尿液NGAL、Cys-C和sTREM-1可作为脓毒症危重患者AKI的诊断和预测生物标志物。
Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis. We divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis. Both plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P <0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair. Plasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.
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