在ICU患者中用尿NGAL和多普勒超声波评估功能:为期1年的观察试点研究
Etrusca Brogi1, Rocco Rago1, Francesco Forfori1
1Department of Anaesthesia and Intensive Care, University of Pisa, 56126 Pisa, Italy.
概括
尿中性粒细胞凝酶相关的利波卡林 (NGAL) 是诊断急性损伤 (AKI) 在重症监护病房中的一个有价值的标志物. 早期的NGAL测量显示在识别AKI患者方面具有很高的准确性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 生物标志物发现发现
背景情况:
- 急性损伤 (AKI) 在重症监护机构中构成了重大挑战.
- 准确及时诊断AKI对于患者的治疗结果至关重要.
- 现有的AKI诊断方法在早期检测方面可能存在局限性.
研究的目的:
- 为了评估尿中性粒细胞凝酶相关性脂卡林 (NGAL) 对AKI的诊断准确性.
- 评估尿NGAL作为重症患者AKI早期诊断标记物的实用性.
- 在重症监护室 (ICU) 设置中确定AKI的预测因素.
主要方法:
- 涉及重症患者的前性研究.
- 每天测量尿中的NGAL和肌,长达3天.
- 多普勒超声波在入院后24小时内进行,并在接下来的3天内进行.
- 在入院时分析血清肌素,长,MDRD和SAPS II分数.
主要成果:
- 44%的患者在ICU停留期间发生了AKI.
- 在所有时间点 (T0,T1,T2) 中,AKI患者的尿NGAL水平显著更高,p<0.0001在T0.
- 尿液NGAL显示了AKI的高诊断准确性,ROC曲线下的面积为0.93和99%的灵敏度在T0.
- 脏长度和T0时的SAPS II也显示出高的诊断性能.
结论:
- 尿液NGAL是一种有价值和准确的生物标志物,用于在重症监护机构诊断AKI.
- 早期测量尿路NGAL可以帮助及时识别AKI.
- 以前存在的慢性病,SAPS II评分和入院NGAL水平是AKI的关键预测因素.
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