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目的 研究急性有机磷中毒（AOPP）患者肾损伤与血清胱抑素-C(Cys-C)、中性粒细胞明胶酶相关蛋白（NGAL）和β2-微球蛋白（β2-MG）的关系。方法 选取2018年1月-2021年1月恩施州中心医院急诊科收治的AOPP患者90例，根据患者是否发生急性肾损伤（AKI）分为AKI组（n=74）和非AKI组（n=16），记录AKI发生率，收集两组患者基本资料，对发生AKI的影响因素进行单因素分析，对有差异的影响因素进行Logistic回归分析，绘制受试者工作特征曲线（ROC），分析Cys-C、NGAL、β2-MG对AOPP发生AKI的预测价值，Pearson法分析Cys-C、NGAL、β2-MG与血肌酐（Scr）相关性。结果 90例AOPP患者中发生AKI 74例，发生率82.22%。与非AKI组比较，AKI组血尿及蛋白尿患者构成比、BUN、Scr、Cys-C、NGAL、β2-MG升高，差异有统计学意义（P<0.05）。Logistic结果显示，Cys-C、NGAL、β2-MG是AOPP患者发生AKI的危险因素。ROC结果显示，血清Cys-C、NGAL、β2-MG单独诊断AKI的最佳截断点分别为1.69 mg/L、6.15 ng/mL、1 146.28μg/L，三者单独及联合诊断的AUC分别为0.713、0.775、0.652、0.825。Pearson相关分析结果显示，血清CysC、NGAL、β2-MG与Scr呈正相关（P<0.05）。结论 AOPP患者AKI发生率较高，血清Cys-C、NGAL、β2-MG与患者肾功能损害程度高度相关，可作为早期诊断AKI的理想指标。
Abstract：Objective To investigate the relationship between renal injury in patients with acute organophosphate pesticide poisoning(AOPP) and serum cystatin-C(Cys-C), neutrophil gelatinase-associated lipocalin(NGAL) and β2-microglobulin(β2-MG). Methods A total of 90 AOPP patients admitted to the hospital from January 2018 to January2021 were selected, patients were divided into AKI group(n=74) and non-AKI group(n=16), according to whether the patients had acute kidney injury(AKI). The incidence of AKI was recorded, and basic data of he patients in two groups were collected. A single factor analysis was performed on influencing factors of AKI, logistic regression analysis was performed on different influencing factors, receiveroperating characteristic curve(ROC) was drawn, the predictive value of Cys-C, NGAL, β2-MG on occurrence of AKI in AOPP were analyzed, and Pearson method was used to analyze the correlation between Cys-C, NGAL, β2-MG and serum creatinine(Scr). Results A total of 74 cases of AKI occurred in 90 AOPP patients with the incidence rate was 82.22%. Compared with non-AKI group, constituent ratio of hematuria, proteinuria, BUN, Scr, Cys-C, NGAL, β2-MG in AKI group increased(P<0.05). Logistic results showed that Cys-C, NGAL, and β2-MG levels were risk factors for AKI in AOPP patients. ROC results showed that the best cut-off points for diagnosis of AKI by serum Cys-C, NGAL, and β2-MG were 1.69 mg/L, 6.15 ng/mL, 1146.28 μg/L respectively, and AUC of three alone and combined diagnosis were 0.713, 0.775, 0.652, 0.825. The results of Pearson correlation analysis showed that serum Cys-C, NGAL, β2-MG and Scr were positively correlated(P<0.05). Conclusion The incidence of AKI is relatively higher in AOPP patients. Serum Cys-C, NGAL and β2-MG are highly correlated with degree of renal impairment in patients and could be used as ideal indicators for early diagnosis of AKI.
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基本信息:
中图分类号:R595.4;R692
引用信息:
[1]邓艳斌,邹振武,段先召.急性有机磷中毒患者肾损伤与血清Cys-C、NGAL、β2-MG的关联研究[J].新疆医科大学学报,2022,45(03):244-249.
基金信息:
湖北省卫生计生委科研项目（WJ2017F097）
2021-06-04
2021
2022-03-21
2022
2021-10-26
1
2022-03-15
2022-03-15