论文部分内容阅读
目的探讨尿微量蛋白作为危重患者预后指标的可行性。方法前瞻性动态监测ICU危重患者尿微量白蛋白(MA)、α1-微球蛋白(α1-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、视黄醇结合蛋白(RBP),并与目前临床常用的预后评估系统APACHEⅡ、SOFA进行比较。结果相关分析结果显示尿MA、α1-MG、NAG、住ICU时间、机械通气时间、APACHEⅡ评分、SOFA与死亡呈正相关。尿MA、α1-MG、住ICU时间、机械通气时间、APACHEⅡ评分、SOFA升高与多器官功能不全综合征(MODS)发生呈正相关。尿MA(r=0．397)、α1-MG(r=0．448)和RBP (r=0．465)与APACHE II评分显著相关。APACHE II评分、SOFA评分、MA、α1-MG、RBP、NAG预测死亡的ROC曲线下面积分别是0．875(P<0．05)、0．825(P<0．05)、0．820(P<0．05)、0．730、0．530、0．620。结论动态监测尿MA、α1-MG、RBP可作为危重患者预后的临床指标。
Objective To investigate the feasibility of urinary microalbumin as a prognostic indicator of critically ill patients. Methods The prospective and dynamic monitoring of urinary albumin (MA), α1-microglobulin (α1-MG), N-acetyl-β-D-glucosaminidase (NAG), retinol binding protein ), And with the current clinical prognosis evaluation system APACHE Ⅱ, SOFA for comparison. Results Correlation analysis showed that urinary MA, α1-MG, NAG, ICU stay, mechanical ventilation time, APACHEⅡscore and SOFA were positively correlated with death. Urinary MA, α1-MG, ICU stay, mechanical ventilation time, APACHEⅡscore and SOFA rise were positively correlated with multiple organ dysfunction syndrome (MODS). Urinary MA (r = 0.397), α1-MG (r = 0.448), and RBP (r = 0.465) were significantly associated with APACHE II scores. The area under the ROC curve of predicted APACHE II score, SOFA score, MA, α1-MG, RBP and NAG were 0.875 (P <0.05), 0.825 (P <0.05), 0.820 (P <0.05), 0.730, 0.530 and 0.620. Conclusions Dynamic monitoring of urinary MA, α1-MG and RBP can be used as clinical indicators of prognosis in critically ill patients.