血清中性粒细胞-明胶酶相关脂钙蛋白(NGAL)在尼日利亚三角洲地区妊娠相关急性肾损伤(PRAKI)诊断中的表现:一项前瞻性研究。

IF 0.7 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Nigerian Journal of Clinical Practice Pub Date : 2025-04-01 Epub Date: 2025-04-26 DOI:10.4103/njcp.njcp_326_24
E P Orhewere, A B Odonmeta, O A Adejumo, O C Okoye
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引用次数: 0

摘要

背景:妊娠相关性急性肾损伤(PRAKI)如果不及时发现,与不良的孕产妇和围产期结局相关。PRAKI的诊断目前是基于血清肌酐,这延误了诊断,并不可避免地延误了治疗。目的:探讨围产期妇女血清NGAL在诊断PRAKI中的作用,并确定非孕妇正常血清NGAL水平。方法:一项前瞻性研究,涉及在三角洲州两家医院分娩的162名孕妇和150名非孕妇对照。在分娩后0、6、12、24、48小时和7天采集研究参与者的血液样本,测定血清肌酐和NGAL。PRAKI的诊断是基于血清肌酐和NGAL。NGAL的诊断性能是通过绘制接受者操作曲线和曲线下面积(AUC)来确定的。结果:以肌酐为基础的KDIGO标准AKI患病率为22.2%,血清NGAL为50%。血清NGAL的最佳诊断准确率是在12小时,使用约登指数确定的142 ng/dl的临界值。未怀孕妇女的参考范围为12.77 - 135.67纳克/分升。血清NGAL在142 ng/ml临界值下的敏感性和特异性分别为77.2%和75.4% (AUC = 0.79),以135.67 ng/ml(非孕妇上限)为临界值,敏感性和特异性分别为77.78%和70.63%。结论:血清NGAL具有较高的敏感性和特异性,是PRAKI早期诊断的良好标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Performance of Serum Neutrophil-Gelatinase Associated Lipocalin (NGAL) in the Diagnosis of Pregnancy-Related Acute Kidney Injury (PRAKI) in Delta, State Nigeria: A Prospective Study.

Background: Pregnancy-related acute kidney injury (PRAKI) is associated with poor maternal and perinatal outcomes if not promptly recognized. Diagnosis of PRAKI is currently based on serum creatinine, which delays diagnosis and, inevitably, treatment.

Aims: To determine the performance of serum NGAL in the diagnosis of PRAKI among women in the peripartum period and determine the normal serum NGAL levels in nonpregnant women.

Methods: A prospective study involving 162 pregnant women who presented in labor in two hospitals in Delta State and 150 nonpregnant controls. Serum creatinine and NGAL were assayed using blood samples collected from study participant at 0, 6, 12, 24, and 48 hours and 7 days postdelivery. Diagnosis of PRAKI was based on both serum creatinine and NGAL. The diagnostic performance of NGAL was determined by performing a receiver operation curve and determining the area under the curve (AUC).

Results: The prevalence of AKI using creatinine-based KDIGO criteria was 22.2% and 50% using serum NGAL. The optimal diagnostic accuracy for serum NGAL was at the 12th hour, using a cut off of 142 ng/dl determined by Youden's index. The reference range for nonpregnant women was 12.77 - 135.67 ng/dl. The sensitivity and specificity of serum NGAL at a cut off 142 ng/ml were 77.2% and 75.4% (AUC = 0.79), respectively while using 135.67 ng/ml (upper limit determined from nonpregnant women) as cut-off, sensitivity was 77.78% and specificity was 70.63%.

Conclusion: Serum NGAL is a promising marker for early diagnosis of PRAKI with high sensitivity and specificity.

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来源期刊
Nigerian Journal of Clinical Practice
Nigerian Journal of Clinical Practice MEDICINE, GENERAL & INTERNAL-
CiteScore
1.40
自引率
0.00%
发文量
275
审稿时长
4-8 weeks
期刊介绍: The Nigerian Journal of Clinical Practice is a Monthly peer-reviewed international journal published by the Medical and Dental Consultants’ Association of Nigeria. The journal’s full text is available online at www.njcponline.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal makes a token charge for submission, processing and publication of manuscripts including color reproduction of photographs.
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