PDF(Pubmed)
Abstract：
A major complication of sepsis is the development of acute kidney injury (AKI). In case of acute tubular damage, Gc-globulin, a known serum sepsis marker is increasingly filtrated into the urine therefore, urinary Gc-globulin (u-Gc) levels may predict septic AKI. We developed and validated a competitive fluorescence ELISA method for u-Gc measurement. Serum and urine samples from septic patients were collected in three consecutive days (T1, T2, T3) and data were compared to controls. Intra- and interassay imprecisions were CV < 14% and CV < 20%, respectively, with a recovery close to 100%. Controls and septic patients differed (p < 0.001) in their u-Gc/u-creatinine levels at admission (T1, median: 0.51 vs. 79.1 µg/mmol), T2 (median: 0.51 vs. 57.8 µg/mmol) and T3 (median: 0.51 vs. 55.6 µg/mmol). Septic patients with AKI expressed higher u-Gc/u-creatinine values than those without AKI at T1 (median: 23.6 vs. 136.5 µg/mmol, p < 0.01) and T3 (median: 34.4 vs. 75.8 µg/mmol, p < 0.05). AKI-2 stage patients exhibited more increased u-Gc/u-creatinine levels at T1 (median: 207.1 vs. 53.3 µg/mmol, p < 0.05) than AKI-1 stage individuals. Moderate correlations (p < 0.001) were observed between u-Gc/u-creatinine and se-urea, se-creatinine, se-hsCRP, WBC, u-total protein, u-albumin, u-orosomucoid/u-creatinine, and u-Cystatin C/u-creatinine levels. U-Gc testing may have a predictive value for AKI in septic patients.
摘要：
脓毒症的主要并发症是急性肾损伤(AKI)的发展。在急性肾小管损伤的情况下，Gc-球蛋白,因此，已知的血清败血症标志物越来越多地过滤到尿液中，尿Gc-球蛋白(u-Gc)水平可预测感染性AKI。我们开发并验证了用于u-Gc测量的竞争性荧光ELISA方法。连续三天（T1，T2，T3）收集脓毒症患者的血清和尿液样品，并将数据与对照组进行比较。测定内和测定间的精确度为CV<14%，CV<20%，分别,恢复接近100%。对照组和脓毒症患者入院时的u-Gc/u-肌酐水平不同（p<0.001）（T1，中位数：0.51vs.79.1µg/mmol），T2（中位数：0.51vs.57.8µg/mmol）和T3（中位数：0.51vs.55.6微克/毫摩尔)。在T1时，有AKI的脓毒症患者的u-Gc/u-肌酐值高于无AKI的患者（中位数：23.6vs.136.5µg/mmol,p<0.01）和T3（中位数：34.4vs.75.8微克/毫摩尔，p<0.05)。AKI-2期患者在T1时表现出更多的u-Gc/u-肌酐水平（中位数：207.1vs.53.3微克/毫摩尔，p<0.05)比AKI-1阶段个体。在u-Gc/u-肌酐和se-尿素之间观察到中等相关性(p<0.001)。肌酐,se-hsCRP，WBC,u-总蛋白，u-白蛋白,u-omosoluid/u-肌酐，和u-胱抑素C/u-肌酐水平。U-Gc检测可能对脓毒症患者的AKI具有预测价值。
