天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (3): 292-295.doi: 10.11958/20171116

• 临床研究 • 上一篇    下一篇

尿中性粒细胞明胶酶相关脂质运载蛋白对儿童急性肾盂肾炎诊断价值的探讨

宋少娜，张碧丽，王文红，张瑄，范树颖   

  1. 天津市儿童医院肾内科（邮编300074）
  • 收稿日期:2017-10-18 修回日期:2018-01-20 出版日期:2018-03-15 发布日期:2018-03-23
  • 通讯作者: 张碧丽 E-mail:zhangbili218@163.com

Discussion on diagnostic value of urinary neutrophil gelatinase-associated lipocalin in the diagnosis of acute pyelonephritis in children

SONG Shao-na, ZHANG Bi-li, WANG Wen-hong, ZHANG Xuan, FAN Shu-ying   

  1. Department of Pediatric Nephrology, Tianjin Children’s Hospital, Tianjin 300074, China
  • Received:2017-10-18 Revised:2018-01-20 Published:2018-03-15 Online:2018-03-23
  • Contact: ZHANG Bili E-mail:zhangbili218@163.com

PDF (PC)

3505

摘要： 目的 探讨尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）对儿童急性肾盂肾炎（APN）的诊断价值。方法 研究对象为 2016 年 12 月—2017 年 5 月收治的尿路感染（UTI）患儿 104 例，包括急性肾盂肾炎 61 例（APN 组）及下尿路感染 43 例（非 APN 组），均检测血清 β2 微球蛋白（β2-MG）、胱抑素 C（CysC）、C 反应蛋白（CRP）、降钙素原（PCT）和尿 NGAL 的水平，对比 2 组各指标的水平，并进行统计学分析；采用受试者工作特征（ROC）曲线分析各指标对 APN 的诊断价值。结果 APN 组血 CRP、PCT、β2-MG 及尿 NGAL 的水平均高于非 APN 组，差异有统计学意义（P＜0.05）；血 CysC 水平差异无统计学意义。血 CRP、PCT 及尿 NGAL 诊断儿童 APN 的 ROC 曲线下面积（AUC）分别为 0.838、0.898、0.963；血 CRP 最佳临界值为 22.6 mg/L 时，敏感度为 75.4%，特异度为 83.7%；PCT 最佳临界值为 0.285 μg/L 时，敏感度为 77.0%，特异度为 93.0%；当尿 NGAL 最佳临界值为 473 μg/L 时，敏感度为 82.0%，特异度为97.7%。结论 尿 NGAL 对儿童 APN 具有诊断价值，有助于临床对儿童 APN 的早期识别。

关键词: 肾盂肾炎, 泌尿道感染, ROC 曲线, 儿童, 中性粒细胞明胶酶相关脂质运载蛋白

Abstract: Objective To explore the diagnostic value of urine neutrophil gelatinase-associated lipocalin (NGAL) in children with acute pyelonephritis. Methods A total of 104 children with urinary tract infection admitted to Tianjin Children’s Hospital from December 2016 to May 2017 were selected in this study, including 61 cases with acutepyelonephritis (group APN) and 43 with lower urinary tract infection (group non-APN). The serum levels of beta 2-Microglobulin (β2-MG), cystatin C (CysC), C-reactive protein (CRP), procalcitonin (PCT) and urine levels of NGAL were compared between two groups. Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic values of serum β2-MG, CysC, CRP, PCT and urine NGAL. Results The serum levels of CRP, PCT, β2-MG and urinary NGAL were significantly higher in APN group than those in non-APN group (P < 0.05). There was no significant difference in serum CysC level between two groups (P > 0.05). The areas under the ROC curve (AUC) for serum CRP, PCT, and urinary NGAL were 0.838, 0.898 and 0.963. The optimal cutoff value of serum CRP was 22.6 mg/L, the sensitivity was 75.4% and the specificity was 83.7%. The optimal cutoff value of serum PCT was 0.285 μg / L, the sensitivity was 77.0%and the specificity was 93.0%. The optimal cutoff value of urine NGAL was 473 μg/L, the sensitivity was 82.0% and the specificity was 97.7%. Conclusion Urinary NGAL has high diagnostic value for APN in children, and which is helpful for the early identification of APN.

Key words: pyelonephritis, urinary tract infections, ROC curve, child, neutrophil gelatinase-associated lipocalin