尿肾损伤分子-1、IL-18及血清胱抑素C联合检测对儿童急性肾损伤早期诊断的价值研究*

doi:10.3969/j.issn.1671-2587.2021.03.018

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (3): 376-379.DOI: 10.3969/j.issn.1671-2587.2021.03.018

尿肾损伤分子-1、IL-18及血清胱抑素C联合检测对儿童急性肾损伤早期诊断的价值研究^*

沈建强, 陈玉梅, 蒋蕾, 吴建刚, 沈燕, 李晓忠

215200 苏州市第九人民医院儿科,苏州市吴江区儿童医院（沈建强,陈玉梅,蒋蕾,吴建刚,沈燕）; 苏州大学附属儿童医院儿科（李晓忠）

收稿日期:2020-07-21 出版日期:2021-06-20 发布日期:2021-06-22
通讯作者: 李晓忠,主任医师,教授,博士,主要从事肾脏疾病、免疫风湿病等相关研究,（E-mail）xiaozhonglicn@yeah.net。
作者简介:沈建强（1976-）,男,江苏吴江人,副主任医师,本科,主要从事肾内科相关疾病诊治, （E-mail）panmei97314@163.com。
基金资助:
*本课题受苏州市科技计划项目（No.SLT201941）资助

Urinary Kidney Injury Molecule-1, IL-18 and Serum Cystatin C Combined Detection in Early Diagnosis of Acute Kidney Injury in Children

SHEN Jian-qiang, CHEN Yu-mei, JIANG Lei, et al

Department of Pediatrics, Suzhou Ninth People's Hospital, Suzhou 215200

Received:2020-07-21 Online:2021-06-20 Published:2021-06-22

摘要/Abstract

摘要： 目的探讨尿肾损伤分子-1、IL-18及血清胱抑素C联合检测对原发性肾病综合征患儿并发急性肾损伤早期的诊断价值。方法对我院收治的153例原发性肾病综合征患儿,检测尿肾损伤分子-1、IL-18及血清胱抑素C。比较不同程度肾损伤患儿的三种指标水平,分析联合检测的诊断价值。结果急性肾损伤组患儿（49/157,32.03%）尿肾损伤分子-1、IL-18及血清胱抑素C水平均高于无急性肾损伤组（108/157,67.97%）（P<0.05）。不同程度急性肾损伤患儿尿肾损伤分子-1、IL-18及血清胱抑素C水平差异均具有统计学意义,且各期两两比较差异均具有统计学意义（P<0.05）。ROC曲线显示：尿肾损伤分子-1、尿IL-18、血清胱抑素C对原发性肾病综合征的患儿合并急性肾损伤诊断截断值分别为3.87μg/mL、271.04 pg/mL、1.23 mg/L ,联合诊断的AUC为0.884,其诊断效能高于单独检查（P<0.05）。结论尿肾损伤分子-1、IL-18及血清胱抑素C均可作为原发性肾病综合征患儿并发急性肾损伤的诊断指标,联合诊断可提高诊断效能。

关键词: 尿肾损伤分子-1, IL-18, 血清胱抑素C, 原发性肾病综合征, 急性肾损伤, 早期诊断

Abstract: Objective To explore the value of combined detection of urinary kidney injury molecule-1, interlukin-18 (IL-18) and serum cystatin C in the early diagnosis of acute kidney injury in children with primary nephrotic syndrome. Methods We enrolled 153 children with primary nephrotic syndrome and detected urinary kidney injury molecule-1, IL-18 and serum cystatin C. We compared the levels of these indicators in children with different degree of renal injury, and analyzed the diagnostic value of combined detection. Results The levels of urine kidney injury molecule-1, IL-18 and serum cystatin C in the acute kidney injury group (49/157, 32.03%) were higher than those without acute kidney injury (108/157, 67.97%) (P<0.05). The levels of urinary renal injury molecule-1, IL-18 and serum cystatin C in children with different acute kidney injury severity levels showed statistically differences (P<0.05). ROC analysis results showed that the diagnostic cut-off values of urinary kidney injury molecule-1, IL-18, and serum cystatin C in children with primary nephrotic syndrome with acute kidney injury were 3.87 μg/mL, 271.04 pg/mL and 1.23 mg/L respectively, and the AUC of combined diagnosis was 0.884, which diagnostic efficiency was higher than that of single examination (P<0.05). Conclusions Urinary kidney injury molecules-1, IL-18 and serum cystatin C can be used as diagnostic indicators for acute kidney injury in children with primary nephrotic syndrome, and combined detection can improve the diagnostic efficiency.

Key words: Urinary kidney injury molecule-1, Interlukin-18 (IL-18), Serum cystatin C, Primary nephrotic syndrome, Acute kidney injury, Early diagnosis

中图分类号:

R446

沈建强, 陈玉梅, 蒋蕾, 吴建刚, 沈燕, 李晓忠. 尿肾损伤分子-1、IL-18及血清胱抑素C联合检测对儿童急性肾损伤早期诊断的价值研究^*[J]. 临床输血与检验, 2021, 23(3): 376-379.

SHEN Jian-qiang, CHEN Yu-mei, JIANG Lei, et al. Urinary Kidney Injury Molecule-1, IL-18 and Serum Cystatin C Combined Detection in Early Diagnosis of Acute Kidney Injury in Children[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2021, 23(3): 376-379.

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尿肾损伤分子-1、IL-18及血清胱抑素C联合检测对儿童急性肾损伤早期诊断的价值研究^*

Urinary Kidney Injury Molecule-1, IL-18 and Serum Cystatin C Combined Detection in Early Diagnosis of Acute Kidney Injury in Children

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