尿IL-18及NGAL在重症急性胰腺炎患者并发急性肾损伤的早期诊断价值

目的探讨尿IL-18及NGAL对急性重症胰腺炎(SAP)患者合并急性肾损伤(AKI)的早期诊断价值。方法 145例急性胰腺炎(AP)患者分为轻型、重型(MAP、SAP)2组,SAP组分非AKI亚组及AKI亚组,设正常对照组。采用ELISA法测定对照组及AP患者发病后12~18 h尿NGAL、IL-18水平。结果尿IL-18在MAP组高于对照组(P<0.05),SAP组明显高于MAP组(P<0.01);尿NGAL在SAP组的AKI亚组明显高于非AKI亚组(P<0.01)。结论尿IL-18水平可以反应AP炎症的严重程度,尿NGAL可以作为SAP合并AKI早期潜在的标记物。

Urinary IL-18 and NGAL as early biomarkers of acute kidney injury following adult severe acute pancreatitis

Severe acute pancreatitis(SAP) is usually complicated by the high incidence of acute kidney injury(AKI).Traditionally,AKI is diagnosed by measuring the increase of the serum creatinine concentration,but it is not a sensitive marker.This clinical study was designed to investigate whether human urinary IL-18 and NGAL can be regarded as early predictive markers for AKI following SAP.Total of 145 cases of acute pancreatitis(AP) patients were divided into the mild acute pancreatitis(MAP) group and SAP group,and the latter is divided into non-AKI subgroup and AKI subgroup,meanwhile control group was set up.Urine samples were collected from control group and the patients with AP after the onset of 12-18 h,then IL-18 and NGAL levels were measured by using an ELISA kit.The urinary IL-18 levels in the MAP group were higher than those in the control group(P<0.05),and those in SAP group were significantly higher than the MAP group(P<0.01);the urinary NGAL levels in AKI subgroup were significantly higher than those in the non-AKI subgroup(P<0.01).For these results,we presume that the urinary IL-18 levels can reflect the severity of AP inflammation,and the urinary NGAL levels can be used as early potential markers of AKI following SAP.