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目的 探讨中性粒细胞明胶酶相关载脂蛋白(neutrophil gelatinase associated lipocalin,NGAL)对百草枯中毒患者急性肾损伤早期诊断及预测价值.方法 选择2013年1月-2015年6月入住菏泽市立医院急诊科的急性百草枯中毒患者,依据急性肾损伤网络组织定义的AKI诊断标准将入选患者分为AKI组(40例)和非AKI组(40例).动态检测并比较两组患者入科时及入院后第1、3、5、7、9天血中性粒细胞明胶酶相关载脂蛋白(sNGAL)、血肌酐、血尿素氮指标.绘制ROC曲线,确定NGAL对早期诊断急性百草枯中毒继发AKI的临床价值.结果 AKI组患者入院时的血清NGAL、血肌酐、尿素氮分别为(62.0±11.0)ng/mL、(93.0±26.0) μmol/L、(8.0± 2.6) mmol/L,非AKI组患者入院时血清NGAL、血肌酐、尿素氮分别为(60.0± 10.0) ng/mL、(76.0±24.0)μmot/L、(4.2±2.0)mmol/L,两组百草枯中毒患者NGAL的基线值(入科时测得值)比较,差异均无统计学意义,而血Scr和BUN的基线值(入科时测得值)比较,差异有统计学意义,非AKI组患者各时间段Scr、BUN、NGAL检测值的比较,差异均无统计学意义,而AKI组患者各时间段NGAL检测值与基线值比较,差异均有统计学意义,且血肌酐、尿素氮各时间段检测值与基线值比较,在入院第3天开始差异有统计学意义,第5天、第7天仍逐步升高;NGAL在入院24h内即明显升高,第3天即达高峰,第5、7、9天仍处于较高水平.ROC曲线分析,血NGAL曲线下面积为0.902,血肌酐曲线下面积为0.813,尿素氮曲线下面积0.798.结论 NGAL可预测急性百草枯中毒患者早期肾损伤,提高了急性百草枯中毒患者肾损伤诊断的特异性和敏感性,对临床诊断、治疗有指导作用.“,”Objective To explore the value of neutrophil gelatinase associated lipocalin (NGAL) in early diagnosis of acute kidney injury (AKI) in paraquat (PQ) poisoning patients.Methods Select January 2013-June 2015 Check-in Heze City Hospital emergency department acute paraquat poisoning patients,according to the diagnostic criteria for acute kidney injury,AKI network organization will be selected to define the patients were divided into AKI group (40 cases) and non-AKI group (40 cases).Motion detection and compared two groups of patients after admission into the department and when 1,3,5,7,9d blood neutrophil gelatinase-associated lipocalin (sNGAL),serum creatinine,blood urea nitrogen index.Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic values of different markers.Results There was no significant difference in the NGAL level between these 2 groups.The serum Cr and BUN levels of the AKI group were both significantly higher in the AKI group than those of the non-AKI group at admission (both P ＜0.05).The serum NGAL,Cr,and BUR levels of the AKI group at different time ponits after admission were all higher than those at admission.The serum NGAL level of the AKI group incerased gradually along with the time,peaked at the third day after admission,remianed at a high level even 9 days later,and the serum NGAL levels of the AKI group at different time points were all significandy higher than those at admission (all P ＜0.05).The serum Cr and BUR levels of the non-AKI group increased gradually after admission and became significantly higher those at admission since the third day after admission (all P ＜0.05).ROC curve analysis showed that the area under curve (AUC) of the blood NGAL was 0.902,the AUC of Cr was 0.813,and the AUC of BUN was 0.798.Conclusion NGAL helps predict early kidney lesion in patients with acute PQ.