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目的:探讨尿液肾损伤分子1(uKIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白分子(uNGAL)在梗阻性肾病所致急性肾损伤(AKI)诊断中的价值,评价其在预测肾脏预后中的价值。方法:收集30例梗阻性肾病患者解除梗阻前后不同时相的尿液标本,应用ELISA方法检测uKIM-1、uNGAL水平,进行分析、比较。随访1年,评估uKIM-1、uNGAL在梗阻性肾病肾脏预后判断中的应用价值。结果:发生AKI的患者uKIM-1和uNGAL水平显著升高,uKIM-1、uNGAL与血清肌酐成正相关,曲线下面积(AUC)分别为0.943和0.900。肾脏预后差的患者术后72h uKIM-1水平显著升高。ROC曲线分析uKIM-1在肾脏预后判断中的AUC为0.912,敏感度85.7%,特异度84.6%。Kaplan-Meier生存曲线分析示出现术后72h尿KIM-1>156.00 pg/(mg·Cr),与不良预后呈明显相关性。结论:uKIM-1、uNGAL对诊断梗阻性肾病所致AKI有较高的准确性,术后72h uKIM-1有助梗阻性肾病肾脏预后的判断。
Objective: To investigate the value of uKIM-1 and uNGAL in the diagnosis of acute renal injury (AKI) induced by obstructive nephropathy In predicting the value of renal prognosis. Methods: Urine samples from 30 patients with obstructive nephropathy were collected before and after obstruction were removed. The levels of uKIM-1 and uNGAL were detected by ELISA, and analyzed. The follow-up of 1 year, uKIM-1, uNGAL assessment of renal prognosis in patients with obstructive nephropathy value. Results: The levels of uKIM-1 and uNGAL in patients with AKI were significantly increased. There was a positive correlation between uKIM-1 and uNGAL and serum creatinine, and the areas under the curve (AUC) were 0.943 and 0.900 respectively. The level of uKIM-1 in patients with poor prognosis of kidney increased significantly at 72 hours after operation. ROC curve analysis of uKIM-1 in the prognosis of renal prognosis of AUC was 0.912, sensitivity 85.7%, specificity 84.6%. Kaplan-Meier survival curve analysis showed that urinary KIM-1> 156.00 pg / (mg · Cr) at 72 hours after operation showed a significant correlation with poor prognosis. Conclusions: uKIM-1 and uNGAL are more accurate in diagnosing AKI caused by obstructive nephropathy. UKIM-1 is helpful to predict the prognosis of obstructive nephropathy in 72 hours after operation.