血浆中性粒细胞明胶酶相关脂钙蛋白联合SOFA评分可用于预测急性肾损伤的预后
Prediction of acute kidney injury prognosis by serum neutrophil gelatinase associated lipocalin combined with SOFA score

卢发菊.血浆中性粒细胞明胶酶相关脂钙蛋白联合SOFA评分可用于预测急性肾损伤的预后[J].内科急危重症杂志,2021,27(4):

扫码阅读全文

DOI：10.11768/nkjwzzzz20210414

中文关键词: 急性肾损伤中性粒细胞明胶酶相关脂钙蛋白 APACHEⅡ评分 SOFA评分预后

英文关键词:

基金项目:

作者	单位	E-mail
卢发菊	青海省第五人民医院	lufa12j@163.com

摘要点击次数: 1613

全文下载次数: 2560

中文摘要:

目的：探讨血浆中性粒细胞明胶酶相关脂钙蛋白（pNGAL）联合序贯器官衰竭评估（SOFA）评分对接受持续肾脏替代治疗（CRRT）的重症急性肾损伤（AKI）患者28d死亡的预测价值。方法：回顾性分析2017年1月-2020年6月在青海省第五人民医院行CRRT的212例重症AKI患者的临床资料，并根据28d内生存情况，分为死亡组和生存组。收集所有患者血浆pNGAL水平并进行急性生理与慢性健康状况评估Ⅱ（APACHEⅡ）评分和SOFA评分，采用Pearson检验分析血浆pNGAL水平与APACHEⅡ评分及SOFA评分的相关性；采用多因素Cox比例风险模型分析患者死亡的独立危险因素。结果： 28d内，212例患者中死亡64例（30.19%），死亡组患者血浆pNGAL水平与APACHEⅡ、SOFA评分呈正相关性（r=0.374、0.381，P均＜0.01）。血浆pNGAL、SOFA评分是28d内AKI患者死亡的独立危险因素（P均＜0.05）。血浆pNGAL水平联合SOFA评分的AUC为0.919（0.897~0.938），特异度为72.85%，灵敏度为100.0%。结论：在行CRRT的重症AKI患者中，SOFA评分联合血浆pNGAL水平对28d内病死率有较高的预测价值。

英文摘要:

Objective: To predict the 28day mortality risk of severe acute kidney injury (AKI) patients receiving continuous renal replacement therapy (CRRT) by evaluating the neutrophil gelatinase associated lipocalin (pNGAL), acute physiology and chronic health assessmentⅡ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score. Methods The clinical data of 212 patients with severe AKI in CRRT from January 2017 to June 2020 in our hospital were retrospectively analyzed. The patients were divided into death group and survival group according to whether they died within 28 days after prognosis. The multivariate Cox proportional hazards model was used to analyze the independent risk factors of death in critically ill AKI patients with CRRT. Results Within 28 days, 64 out of 212 patients died, with a mortality rate of 30.19%. The pNGAL was positively correlated with APACHEⅡ score (r=0.374, P< 0.001). There was a positive correlation between pNGAL and SOFA score (r=0.381,P<0.001). The results of three models showed that pNGAL and SOFA scores were the independent risk factors of AKI patients' death within 28 days (P<0.05). The AUC of pNGAL combined with SOFA score was 0.919 (0.8970.938), the specificity was 72.85%, and the sensitivity was 100.0%. Conclusion: The pNGAL concentration and SOFA score are independent predictors of death within 28 days in severe AKI patients with CRRT, and the combination of them can further improve the accuracy of prediction.