中性粒细胞明胶酶相关脂质运载蛋白、肾损伤分子-1 联合尿微量白蛋白检测对胰腺炎并发急性肾损伤的诊断价值

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Abstract Objective To analyze the value of urine neutrophil gelatinase-associated lipocalin (NGAL),kidney injury molecule-1 (KIM-1)and urinary microscale albuminuria (MAU)detection in the early diagnosis of acute pancreatitis(AP)complicated with acute kidney injury (AKI).Methods A total of 120 AP patients admitted to Beijing Jishuitan Hospital Guizhou Hospital from July 2020 to July 2023 were selected as the research objects.According to whether AKI occurred within 7 d after admission,they were divided into AKI group and non-AKI group.Urine was collected on the day of admission and NGAL,KIM-1 and MAU levels were detected.The general data and urine NGAL,KIM-1 and MAU levels of the two groups were compared,and the correlation between NGAL,KIM-1 and MAU levels and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores were analyzed.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of NGAL,KIM-1 and MAU alone and in combination for AP complicated with AKI.Results There were no significant differences in age,sex,body mass index (BMI),history of diabetes,history of hypertension,time from onset to admission,and baseline serum creatinine level between two groups (P＞0.05).The APACHEⅡscore in AKI group was higher than that in non-AKI group,and the difference was statistically significant (P＜0.05).The levels of urine NGAL,KIM-1 and MAU in AKI group were higher than those in non-AKI group,with statistical significances (P＜0.05).Pearson correlation analysis showed that urine NGAL,KIM-1 and MAU levels were positively correlated with APACHEⅡscores(P＜0.05).ROC curve showed that the best cutoff values of urine NGAL,KIM-1 and MAU for predicting AP concurrent AKI were 158.50 ng/ml,3.23 ng/ml and 23.85 mg/L,respectively,the corresponding AUC were 0.872,0.853 and 0.841,and the AUC for combined diagnosis was 0.912.Conclusion Urine NGAL,KIM-1 and MAU detection have high predictive value for AP complicated with AKI,and can improve the early diagnosis efficiency.

Key words： Acute pancreatitis Acute kidney injury Neutrophil gelatinase-associated lipocalin Kidney injury molecule-1 Microscale albuminuria Diagnostic value

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