检验医学与临床2025，Vol.22Issue(8)：1039-1044,6.DOI:10.3969/j.issn.1672-9455.2025.08.007
血清NGAL、KIM-1、ACTH对肾结石患者微通路经皮肾镜碎石术后发生肾功能损伤的预测价值
Predictive value of serum NGAL,KIM-1 and ACTH for renal function injury after microaccess percutaneous nephrolithotomy in patients with kidney stones
摘要
Abstract
Objective To investigate the predictive value of serum neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1)and adrenocorticotropic hormone(ACTH)for renal injury after microaccess percutaneous nephrolithotomy(MPCNL)in patients with kidney stones.Methods A total of 260 patients with kidney stones admitted to the Second Affiliated Hospital of Xingtai Medical College from April 2021 to August 2023 were selected as the research subjects.According to whether renal function injury oc-curred,they were divided into renal function injury group and non-renal function injury group.The serum lev-els of NGAL,KIM-1 and ACTH were compared between the two groups before and after operation.Pearson correlation analysis was used to analyze the correlation between serum NGAL,KIM-1,ACTH levels at 12 and 24 h after operation and serum creatinine level at 48 h after operation in patients with kidney stones.Multiva-riate Logistic regression was used to analyze the influencing factors of renal function injury after MPCNL in patients with kidney stones.The receiver operating characteristic(ROC)curve was drawn to analyze the pre-dictive efficacy of serum NGAL,KIM-1 and ACTH for renal function injury after MPCNL in patients with kidney stones.Results Repeated measures analysis of variance showed that there were inter-group,time and interaction effects in serum NGAL,KIM-1 and ACTH levels before and after operation in the two groups(P<0.05).The levels of serum NGAL,KIM-1 and ACTH in the two groups at 24 h and 48 h after operation were significantly higher than those before operation and 12 h after operation(P<0.05),and the levels at 12 h after operation were higher than those before operation(P<0.05).The levels of serum NGAL,KIM-1 and ACTH in patients with renal function injury at 12 and 24 h after operation were significantly higher than those in patients without renal function injury(P<0.05).The results of Pearson correlation analysis showed that the serum NGAL,KIM-1,ACTH levels of 260 patients with kidney stone at 12 h after operation were posi-tively correlated with the serum creatinine level at 48 h after operation(r=0.857,0.890,0.671,P<0.001).The levels of serum NGAL,KIM-1 and ACTH at 24 h after operation were positively correlated with the level of serum creatinine at 48 h after operation(r=0.753,0.634,0.654,P<0.001).The results of multivariate Logistic regression analysis showed that the increase of serum NGAL,KIM-1 and ACTH levels at 12 and 24 h after operation were risk factors for renal function injury in patients with kidney stones after MPCNL(P<0.05).ROC curve analysis showed that the area under the curve of serum NGAL,KIM-1 and ACTH at 12 and 24 h after operation to predict renal function injury after MPCNL in patients with kidney stones was 0.955.Conclusion The abnormal expression of serum NGAL,KIM-1 and ACTH in patients with renal calculi at 12 h and 24 h after MPCNL can predict the postoperative renal function injury.关键词
中性粒细胞明胶酶相关脂质运载蛋白/肾损伤分子-1/促肾上腺皮质激素/肾结石/微通道经皮肾镜碎石术/肾功能Key words
neutrophil gelatinase-associated lipocalin/kidney injury molecule-1/adrenocorticotropic hormone/kidney stone/microaccess percutaneous nephrolithotomy/renal function分类
医药卫生引用本文复制引用
牛忠涛,袁宏毅,郝强,李娜,乔玉华..血清NGAL、KIM-1、ACTH对肾结石患者微通路经皮肾镜碎石术后发生肾功能损伤的预测价值[J].检验医学与临床,2025,22(8):1039-1044,6.基金项目
河北省邢台市重点研发计划项目(2021ZC182). （2021ZC182）
