| Objective:The incidence and mortality of severe burn complicated with acute renal injury are high,and early diagnosis is an effective method to avoid aggravation and improve AKI.This study was designed to compare the differences and correlations of NGAL,SCr and BUN in severe burn patients with and without Ak I and healthy volunteers,in order to provide theoretical basis for early Aki prediction and diagnosis of NGAL.Methods:1.According to the inclusion and exclusion criteria,the burn patients were selected,and the general data of burn patients and healthy volunteers were analyzed.NGAL concentration was determined by ELISA examination,albumin,SCr and BUN were detected by automatic biochemical analyzer.The differences of age,sex,NGAL,albumin,SCr and BUN were compared.2.NGAL,SCr,WBC,albumin and BUN were measured at 2h,24 h,48h and 72 h in burn group.The differences of these indexes between AKI Group and non-AKI group were compared.3.The correlation between NGAL and WBC,albumin,BUN and SCr in patients with AKI was analyzed.4.The ROC curves of NGAL and SCR in urine at 2h and 24 h were plotted,the area under the curves(AUC)and the Yorden Index were calculated,and the specificity and sensitivity of these two methods for Aki diagnosis were analyzedResults:1.The values of NGAL and albumin in urine of burn group were significantly higher than those of healthy control group on the day of admission(p < 0.01).There was no significant difference in SCR(P > 0.05).In burn patients,there was no significant difference in sex and mean age between AKI Group and non-AKI group(P > 0.05),but there was significant difference in mean total burn area(p < 0.01).2.The NGAL of urine in AKI group was significantly different from that of non-AKI group at 2H,24 h,48h and 72h(p < 0.05),but the difference was found only at 48 h and 72h(p < 0.01).Bun was also significantly different at 48 h and 72 h,there was significant difference between the two groups(p < 0.05),WBC at 72 hours,there was significant difference between the two groups(p < 0.05),the rest of the measured values at any time point had no significant difference(P > 0.05).3.Correlation analysis showed that the NGAL level in urine of AKI patients was positively correlated with WBC at 72h(p < 0.05).At 2h and 24 h after admission,there was no correlation with SCR(P > 0.05),but at 48 h and 72 h,there was positive correlation with SCR(P < 0.05).4.The area under ROC curve(AUC)of Ngal and SCR in urine for diagnosis of AKI at 2 h after admission was 0.847(95% CI: 0.712 ~ 0.981,p < 0.05),0.514(95% CI: 0.316 ~ 0.711,p < 0.05),the threshold value was determined by the MDI.When the NGAL truncation value was 54.52 μg/l,the diagnostic sensitivity and specificity of NGAL were 71.4% and 89.7% respectively The area under ROC curve(AUC)of NGAL and SCR were 0.884(95% CI: 0.774 ~ 0.994,p < 0.05)and 0.592(95% CI: 0.402 ~ 0.781,p < 0.05),respectively,when the NGAL cut-off value of urine was 153.36 μg/l,the sensitivity of diagnosis was 76.2%,the specificity was 92.9%.Conclusion:1.Urinary NGAL is an early diagnostic marker for AKI in severely burned patients.2.Urinary NGAL can predict the occurrence of AKI in severe burn patients earlier than SCr. |
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