CysC、NGAL和IL-18对肾病综合征所致急性肾损伤的诊断价值-海南医学.PDFVIP

doi:10.3969/j.issn.1003-6350.2014.01.0019 ·论 著· CysC、NGAL和IL-18对肾病综合征所致急性肾损伤的诊断价值 李冰心，周小兵，杨 林，夏敬彪，张祥文 （宜昌市三峡大学第一临床医学院，湖北 宜昌 443003 ） 【摘要】 目的 探讨血清胱抑素C (Cys C)和尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞介 素-18 (IL-18)对原发性肾病综合征(PNS)导致的急性肾损伤(AKI)的诊断价值。方法 收集我院PNS 患者60 例， 其中PNS 未并发AKI (非AKI 组)患者38 例，PNS 并发AKI 患者(AKI 组) 22 例。检测血清Cys C、血肌酐、尿素氮、 血脂、白蛋白、24 h 尿蛋白定量水平，采用ELISA 方法检测尿NGAL 和IL-18水平。结果 AKI 组血清Cys C、尿 NGAL 和IL-18显著高于非AKI 组，差异有统计学意义。AKI 组血Cys C、尿NGAL 和IL-18与肌酐呈正相关，与 eGFR 呈负相关。多因素Logistic 回归分析结果显示血Cys C、尿NGAL 和IL-18升高是PNS 并发AKI 的独立危 险因素。结论 血清Cys C、尿NGAL 和IL-18对诊断PNS 导致的AKI 有较高的准确性。 【关键词】 急性肾损伤；胱抑素C ；中性粒细胞明胶酶相关脂质运载蛋白；白细胞介素-18 【中图分类号】R692 【文献标识码】A 【文章编号】 1003—6350(2014)01—0053—03 ValueofCysC,NGALandIL-18inthediagnosisofacutekidneyinjurycausedbynephroticsyndrome. LI Bing-xin,ZHOUXiao-bing,YANGLin,XIAJing-biao,ZHANGXiang-wen.TheFirstCollegeofClinicalMedical Science,ThreeGorgesUniversity,Yichang443003,Hubei,CHINA 【Abstract】 Objective To assess the values of serum cystatin C (Cys C) and urinary neutrophil gelatinase-as- sociated lipocalin (NGAL), interleukin-18 (IL-18) in the diagnosis of acute kidney injury (AKI) caused by primary ne- phrotic syndrome (PNS). Methods Sixty patients with PNS were collected in our hospital, including 38 not compli- cated with AKI (non-AKI group) and 22 complicated with AKI (AKI group). The levels of serum Cys C, serum creati- nine, urea nitrogen, serum lipid, albumin and 24 h urinary protein were measured. Urinary NGAL and IL-18 levels were measured by ELISA. Results The levels of serum Cys C, urinary NGAL and IL-18 in AKI group were signifi- cantly higher than those in non-AKI group. The levels of serum Cys C, urinary NGAL, IL-18 were p