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Measurement and clinical significance of plasma neutruphil gelatinase associated lipocalin concentration in shock patients

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Author:
YU Xue-tao(Department of Intensive Care Unit,Longgang District People's Hospital of Shenzhen,Guangdong Province,Shenzhen 518172,China)
LIU Mei-miao(Department of Intensive Care Unit,Longgang District People's Hospital of Shenzhen,Guangdong Province,Shenzhen 518172,China)
QIU Wen-bing()
WU Zhao-xi()
FANG Wei-qiang()
LI En-min()
Journal Title:
China Medicine
Issue:
Volume 07, Issue 11, 2012
DOI:
10.3760/cma.j.issn.1673-4777.2012.11.001
Key Word:
Neutrophil gelatinase associated lipocalin;Shock;Sequential organ failure assessment

Abstract: Objective To detect the concentration of plasma neutrophil gelatinase associated lipocalin (NGAL) and it's clinical significance in shock patients.Methods All 38 patients in intensive care unit (ICU)were enrolled.Serial blood samples were drawn from patients for NGAL measuring and acute physiology and chronic health evaluation (APACHE) Ⅱ and sequential organ failure assessment (SOFA) score were performed.Plasma NGAL concentration was measured by enzyme-linked immunosorbent assay (ELISA).Results Of 38 cases,10 patients were shock cases,another 28 cases with non-shock when admitted to the hospital,and 17 patients got worse and 21 patients were improved in hospital.Compared with non-shock patients,plasma NGAL,serum creatinine,blood glucose and prothrombin time-international normal ration (PT-INR) of shock patients were higher [(147 ±113) μg/L vs (59 ± 64) μg/L,(201 ± 93) μmol/L vs (132 ± 106) μmol/L,(13.5 ± 6.1) mmol/L vs (9.0 ±3.0) mmol/L,(1.23 ± 0.33) vs (1.00 ± 0.12),respectively] ; bicarbonate radical (HCO3-) and platelet were lower [(18±5)mmol/L vs(25±6)mmol/L,(115±61) × 109/L vs(161 ±57) × 109/L,respectively] when admitted to ICU (P <0.05 or P <0.01).Areas under the receiver operating characteristic curves (ROC curves) of NGAL,APACHE Ⅱ and SOFA scores for hospital mortality were 0.717 [95% confident interval(CI) 0.550-0.884,P <0.05],0.770 (95% CI 0.616-0.925,P < 0.01) and 0.796 (95% CI 0.650-0.937,P < 0.01).Plasma NGAL concentration greater than 79.56 μg/L was an indicator for mortality; the sensitivity and the specificity was 52.9%and 90.5% respectively.Conclusion Combining the plasma NGAL levels with APACHE Ⅱ or SOFA score may contribute to evaluation of the severity and prognosis of shock patients.

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