The value of neutrophil gelatinase-associated lipocalin and neutrophil-to-lymphocyte and platelet ratio in the early prediction of kidney injury in elderly patients with Diquat poisoning
10.3760/cma.j.issn.0254-9026.2022.11.011
- VernacularTitle:中性粒细胞明胶酶相关脂质运载蛋白和中性粒细胞与淋巴细胞及血小板比值检测对敌草快中毒老年患者肾损伤的早期预测价值
- Author:
Hongna QI
1
;
Jia LI
;
Qingmian XIAO
;
Baoyue ZHU
;
Weizhan WANG
Author Information
1. 河北医科大学哈励逊国际和平医院急救医学部，衡水 053000
- Keywords:
Diquat;
Poisoning;
Lipocalins;
Kidney injury
- From:
Chinese Journal of Geriatrics
2022;41(11):1327-1332
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of neutrophil gelatinase-associated lipocalin(NGAL)and neutrophil-to-lymphocyte and platelet ratio(NLPR)for early prediction of kidney injury with Diquat(DQ)poisoning in elderly patients.Methods:In this retrospective study, a total of 106 elderly patients with DQ poisoning treated in the Emergency Intensive Care Unit(EICU)of Harrison International Peace Hospital Affiliated to Hebei Medical University between October 2019 and October 2021 were divided into an acute kidney injury group(AKI group, n=62)and a non-acute kidney injury group(NAKI group, n=44). Meanwhile, 40 non-elderly patients with DQ poisoning served as the control group.Samples of 5 ml venous blood were collected from patients admitted to the EICU to measure NGAL and NLPR levels and Logistic regression analysis was conducted to analyze independent risk factors for AKI in elderly DQ poisoning patients.The area under the curve(AUC)was calculated via the receiver operating characteristic(ROC)curve, and the value of NGAL and NLPR for early prediction of AKI in elderly patients with DQ poisoning and patient prognosis was assessed.Results:Blood NGAL and NLPR levels in the AKI group were significantly higher than in the NAKI group[(387.1±46.6)μg/L vs.(103.5±18.6)μg/L, (13.5±3.4) vs.(5.3±1.1), t=38.243, 15.608, P<0.001 for both]. Logistic regression analysis results showed that elevated levels of NGAL( OR=1.009, 95% CI: 1.003-1.015, P<0.001)and NLPR( OR=1.263, 95% CI: 1.039-1.536, P<0.001)were risk factors for AKI in elderly patients with DQ poisoning.The areas under the ROC curves of NGAL, NLPR and NGAL+ NLPR for AKI prediction were 0.834, 0.803 and 0.873 respectively.The predictive power of NGAL and NLPR for the death of elderly patients with DQ poisoning was higher than that of creatinine clearance(Ccr). The sensitivity of the combination of the two to predict the risk of death was 0.850, the specificity was 0.828, and the AUC was 0.887. Conclusions:NGAL and NLPR are independent risk factors for the occurrence of AKI in elderly patients with DQ poisoning.Combined detection of NGAL and NLPR improves AKI prediction and prognosis assessment in elderly patients with DQ poisoning.
