尿NGAL、KIM-1和IL-18联合检测对儿童急性肾损伤早期诊断的价值

目的 探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)及白细胞介素-18(IL-18)联合检测在儿童急性肾损伤(AKI)早期诊断中的价值.方法 选择2015年1月至2016年8月期间石家庄市第一医院儿科诊治的32例AKI患儿为研究对象,检测不同时间及不同分期AKI患儿尿NGAL、KIM-1、IL-18和血肌酐的变化.结果 AKI患儿尿NGAL、KIM-1、IL-18在诊断前3 d分别为(1.23±0.28)μg/mL、(37.58±5.88)ng/mL、(30.35±6.21)ng/mL,在诊断前2 d分别为(1.77±0.39)μg/mL、(43.29±6.32)ng/mL、(36.49±9.35)ng/mL,及诊断前1 d水平(2.28±0.71)μg/mL、(60.38±12.83)ng/mL、(58.32±20.12)ng/mL,均明显依次升高,差异均有统计学意义(P<0.05);但是血肌酐在诊断前1 d与诊断前2 d、3 d比较差异均无统计学意义(P>0.05);尿NGAL、KIM-1、IL-18及血肌酐水平在AKI 1期为(2.68±0.48)μg/mL、(69.23±5.31)ng/mL、(65.84±6.43)ng/mL,2期为(3.19±0.41)μg/mL、(60.38±12.83)ng/mL、(73.29±6.68)ng/mL,3期为(3.81±0.42)μg/mL、(89.67±6.22)ng/mL、(81.31±7.42)ng/mL,均依次升高,差异均有统计学意义(P<0.05).结论 尿NGAL、KIM-1、IL-18在儿童AKI早期即可明显升高,三者联合检测对早期诊断儿童AKI具有重要意义.

Value of combined detection of urinary NGAL,KIM-1 and IL-18 in early diagnosis of children with acute kidney injury.

Objective To investigate the value of combined detection of urinary neutrophil gelatinase-associat-ed lipocalin (NGAL), renal injury molecule-1 (KIM-1) and interleukin-18 (IL-18) in early diagnosis of children with acute kidney injury (AKI). Methods Thirty-two cases of children with AKI who diagnosed and treated in Department of Pediatrics in the First Hospital of Shijiazhuang from January 2015 to August 2016 were enrolled in this study. The changes of urinary NGAL, KIM-1, IL-18 and serum creatinine (Scr) in children with AKI at different time and different stages were compared. Results The levels of urinary NGAL, KIM-1 and IL-18 in the children with AKI were signifi-cantly increased at 3 d, 2 d, 1 d before diagnosis in turn:at 3 d before diagnosis (1.23±0.28)μg/mL, (37.58±5.88) ng/mL, (30.35±6.21) ng/mL, 2 days before diagnosis (1.77±0.39)μg/mL, (43.29±6.32) ng/mL, (36.49±9.35) ng/mL, and 1 day before diagnosis (2.28 ± 0.71)μg/mL, (60.38 ± 12.83) ng/mL, (58.32 ± 20.12) ng/mL, with statistically significant differ-ence (P<0.05);However, there was no significant difference in Scr between at 1 d and the 2 d, 3 d before diagnosis (P>0.05). Urinary NGAL, KIM-1, IL-18 and Scr levels were significantly increased in AKIⅠ,Ⅱ,Ⅲstages in turn:AKIⅠstage (2.68±0.48)μg/mL, (69.23±5.31) ng/mL, (65.84±6.43) ng/mL,Ⅱstage (3.19±0.41)μg/mL, (60.38±12.83) ng/mL, (73.29±6.68) ng/mL, andⅢstage (3.81±0.42)μg/mL, (89.67±6.22) ng/mL, (81.31±7.42) ng/mL, with statistically signif-icant difference (P<0.05). Conclusion Urinary NGAL, KIM-1 and IL-18 were significantly elevated in children with early AKI, and the combined detection of them have great significance in the early diagnosis of AKI in children.