尿肾损伤分子-1在急性肾损伤诊断中的临床价值

目的探讨尿肾损伤分子-1(Kidney injury molecule-1,Kim-1)在急性肾损伤诊断中的敏感性及临床价值。方法选择2010年1月至2011年6月在我科住院的急性肾损伤患者58例作为病例组,健康体检者20例为对照组。尿Kim-1、微量白蛋白(mALB)测定采用酶联免疫吸附法(ELISA),尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)测定采用对硝基苯酚(PNP)比色法。结果急性肾损伤组患者尿液中的Kim-1、NAG、mALB的测定浓度明显高于对照组,差异具有统计学意义(P<0.01),我们通过ROC曲线、诊断试验结果显示:尿Kim-1曲线下面积为0.956,95%可信区间为0.910～1.001,较尿NAG、mALB更具有敏感性(P<0.001),两组间患者年龄及男女比例差异均无统计学意义(P>0.05)。结论尿Kim-1在急性肾损伤诊断中起着重要的作用,检测尿Kim-1的浓度可以成为急性肾损伤患者无创并有效的检测手段,有助于急性肾损伤的早期监测,对预防急性肾损伤的发生、发展具有重要的临床价值。

Clinical value of urine kidney injury molecular-1 in the diagnosis of acute kidney injury

Objective To study the sensitivity and clinical value of kidney injury molecule-1(Kim-1) in the diagnosis of acute kidney injury.Methods 58 patients with acute kidney injury were selected as the study group,and 20 healthy individuals were enrolled as the control group from Jan.2010 to Jun.2011.Kim-1 and urine mALB were determinated with ELISA,and urine NAG with phenol(PNP) colorimetric method.Results The concentration of urine Kim-1 and mALB NAG,in the study group were significantly higher than those in the control group,with statistically significant differences(P<0.001).Through the ROC curves,diagnostic test showed:Kim-1 curve urine area under 0.956,95% CI 0.910 to 1.001,and was more sensitive than urine NAG,mALB(P<0.001) between the two groups.Patients age and sex ratio were no statistically significant differences.Conclusion As a noninvasive method,urine Kim-1 plays an important role in acute renal damage diagnosis,prevention andearly detection.