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首页> 外文期刊>BMC Pediatrics >Urinary Neutrophil Gelatinase-associated Lipocalin in the evaluation of Patent Ductus Arteriosus and AKI in Very Preterm Neonates: a cohort study
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Urinary Neutrophil Gelatinase-associated Lipocalin in the evaluation of Patent Ductus Arteriosus and AKI in Very Preterm Neonates: a cohort study

机译：尿中性粒细胞明胶酶相关脂蛋白的评估早产儿动脉导管未闭和AKI的队列研究

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Background A patent ductus arteriosus (PDA) is frequently found in very preterm neonates and is associated with increased risk of morbidity and mortality. A shunt across a PDA can result in an unfavorable distribution of the cardiac output and may in turn result in poor renal perfusion. Urinary Neutrophil Gelatinase-associated Lipocalin (U-NGAL) is a marker of renal ischemia and may add to the evaluation of PDA. Our primary aim was to investigate if U-NGAL is associated with PDA in very preterm neonates. Secondary, to investigate whether U-NGAL and PDA are associated with AKI and renal dysfunction evaluated by fractional excretion of sodium (FENa) and urine albumin in a cohort of very preterm neonates. Methods A cohort of 146 neonates born at a gestational age less than 32?weeks were c onsecutively examined with echocardiography for PDA and serum sodium, and urine albumin and sodium were measured on postnatal day 3 and U-NGAL and serum creatinine day 3 and 6. AKI was defined according to modified neonatal Acute Kidney Injury Network (AKIN) criteria. The association between U-NGAL and PDA was investigated. And secondly we investigated if PDA and U-NGAL was associated with AKI and renal dysfunction. Results U-NGAL was not associated with a PDA day 3 when adjusted for gestational age and gender. A PDA day 3 was not associated with AKI when adjusted for gestational age and gender; however, it was associated with urine albumin. U-NGAL was not associated with AKI, but was found to be associated with urine albumin and FENa. Conclusions Based on our study U-NGAL is not considered useful as a diagnostic marker to identify very preterm neonates with a PDA causing hemodynamic changes resulting in early renal morbidity. The interpretation of NGAL in preterm neonates remains to be fully elucidated.
机译：背景技术动脉导管未闭（PDA）经常在早产儿中发现，并与发病和死亡的风险增加有关。 PDA上的分流器可能导致心输出量的不利分布，进而导致肾灌注不良。尿中性粒细胞明胶酶相关的脂蛋白（U-NGAL）是肾缺血的标志物，可能会增加PDA的评估。我们的主要目的是研究早产儿中U-NGAL是否与PDA相关。其次，研究在极早产儿队列中，U-NGAL和PDA是否与AKI和肾功能不全有关，通过钠（FENa）和尿白蛋白的分数排泄评估。方法采用超声心动图法对146例胎龄小于32周的新生儿进行PDA和血清钠的超声检查，并在出生后第3天，U-NGAL和血清肌酐第3和6天进行尿白蛋白和钠的测定。 。AKI是根据改良的新生儿急性肾损伤网络（AKIN）标准定义的。研究了U-NGAL和PDA之间的关联。其次，我们调查了PDA和U-NGAL是否与AKI和肾功能不全有关。结果在调整胎龄和性别后，U-NGAL与PDA第3天无关。调整胎龄和性别后，第3天的PDA与AKI无关。但是，它与尿白蛋白有关。 U-NGAL与AKI不相关，但被发现与尿白蛋白和FENa相关。结论根据我们的研究，U-NGAL不能被认为是诊断具有PDA的早产新生儿的诊断指标，PDA会引起血液动力学变化并导致早期肾脏发病。早产新生儿对NGAL的解释仍有待充分阐明。

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