RESUMO
Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
RESUMO
Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
RESUMO
Objective To assess the predictive value of neutrophil gelatinase associated protein lipocalin (uNGAL) in urine for detection of acute kidney injury(AKI) in patients with severe traumatic brain injury. Methods Patients with severe traumatic brain injury from the ICU were collected from Jan. 2011 to May. 2013 in our hospital. 43 cases that met the RIFLE criteria for diagnosis of AKI in the ICU within 7 days were selected as AKI group. Another 43 cases that were matched for age ,gender ,illness severity , surgery method with AKI cases ,selected as non‐AKI group. The levels of uNGAL and Scr were measured when the patients admit‐ted in the ICU with 15 min ,at 24 h ,48 h ,72 h. the sensitivity and specificity of uNGAL and Scr for diagnosis for AKI were evalua‐ted by ROC curve. Results The incidence of severe traumatic brain injury AKI was 42. 16% (43/102). The uNGAL levels in the AKI group were higher when the patient stayed in the ICU longer and no obvious in the non AKI group. When admitted to the ICU 24 h ,the level of uNGAL(720. 32 ± 684. 25)ng/mL in AKI group was significantly higher than that (421. 92 ± 351. 20)ng/mL in non AKI group. The difference was statistically significant (P< 0. 05). The levels of Scr between two groups were not statistically significant. The area under ROC curve of uNGAL and Scr were 0. 879 (95% CI :0. 807 - 0. 949) and 0. 612 (95% CI :0. 493 -0. 731). When the cutoff value of uNGAL was 180 ng/mL ,the sensitivity and specificity were 0. 890 and 0. 823 respectively. The sensitivity was superior to Scr. Conclusion uNGALis superior to Scr for early diagnosis of AKI in patients with severe traumatic brain injury and it could be used as a biomarker for early diagnosis of AKI.
