广西医学2024，Vol.46Issue(4)：495-500,6.DOI:10.11675/j.issn.0253-4304.2024.04.06
血清NGAL水平联合APACHEⅡ评分对重症肺炎并发急性肾损伤患者预后的预测价值
Predictive value of serum NGAL level combined with APACHEⅡ score on prognosis in patients with severe pneumonia and concomitant acute kidney injury
摘要
Abstract
Objective To investigate the predictive value of serum neutrophil gelatinase associated lipocalin(NGAL)level combined with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score on prognosis in patients with severe pneumonia and concomitant acute kidney injury(AKI).Methods A total of 161 patients with severe pneumonia and concomitant AKI were selected as AKI group,and 80 patients with severe pneumonia alone as non-AKI group.Patients of the AKI group were further assigned to death group(n=54)or survival group(n=107)according to prognostic status 30 days after admission.The level of serum NGAL and APACHEⅡ score were compared between the AKI group and the non-AKI group.The clinical data of patients were compared between the death group and the survival group.The multivariate Logistic regression model was used to analyze the influencing factors for prognosis in patients with severe pneumonia and concomitant AKI.The predictive value of serum NGAL level combined with APACHEⅡ score on prognosis of patients with severe pneumonia and concomitant AKI was evaluated by drawing the receiver operating characteristic(ROC)curve.Results Compared with the non-AKI group,the AKI group exhibited elevated serum NGAL level and APACHEⅡscore(P＜0.05).Increase of age,AKI stage in 2-3,elevation of serum NGAL level,and increase of APACHEⅡ score were the independent risk factors for prognosis in patients with severe pneumonia and concomitant AKI(P＜0.05).The results of ROC curve analysis revealed that area under the curve of serum NGAL level combined with APACHEⅡ score for predicting prognosis in patients with severe pneumonia and concomitant AKI was 0.873,which was larger than areas under the curve predicted by serum NGAL level and APACHEⅡ score alone(P＜0.05).Conclusion The elevations of serum NGAL level and APACHEⅡ score in patients with severe pneumonia and concomitant AKI are closely associated with adverse prognosis,serum NGAL level combined with APACHEⅡ score on prognosis of patients with severe pneumonia and concomitant AKI exerts relatively high prediction efficiency.关键词
重症肺炎/急性肾损伤/中性粒细胞明胶酶相关脂质运载蛋白/急性生理和慢性健康状况评估Ⅱ评分/预后/预测效能Key words
Severe pneumonia/Acute kidney injury/Neutrophil gelatinase associated lipocalin/Acute Physiology and Chronic Health Evaluation Ⅱ score/Prognosis/Prediction efficiency分类
医药卫生引用本文复制引用
张鸥,周祥林,吴萍,顾建军,聂辰,彭怡琳,周峰..血清NGAL水平联合APACHEⅡ评分对重症肺炎并发急性肾损伤患者预后的预测价值[J].广西医学,2024,46(4):495-500,6.基金项目
江苏省卫生健康委员会医学科研项目(JH19019) （JH19019）
