Study On The Association Between NGAL,Cys-C With Acute Kidney Injury By Acute Organophosphate Pesticide Poisoning

Objective:To campare the positive proportion,sensitivity and specificity of the four acute kidney injury(AKI) markers, and study the relation with intoxation degree through testing the concentrations of serum neutrophil gelatinase-associated lipocalin (NGAL),cystatin C(Cys-C) in acute organophosphate pesticide poisoning(AOPP) patients, so as to improve the positive rate in the diagnosis of AKI in AOPP, and provide support for prevention and treatment of AKI.Methods:105 patients of AOPP were divided into three groups (gently,midrange,severity) according to acetylcholinesterase(AchE), and the sample size was 35,38, and 32 respectively. Thirty healthy controls in out-patient clinic were also recruited. Serum NGAL,Cys-C and Scr were detected in the healthy controls, and in the patients on the admission, 1d,3d and 5d after admission. The relation of the two biomarkers with intoxication degree and time was then analyzed, respectively. At last, the difference of these markers'positive proportion, sensitivity and specificity was also evaluated.Results:The incidence of AKI caused by AOPP was 86.7%.The sensitivity of NGAL is 87.9%, which was higher than Cys-C (58.2%),and the difference reached significant deviation (P＜0.01). The specificities of NGAL, Cys-C were 100%.In 1d after admission,the positive proportion of NGAL was 76.2%, which was significant higher than Cys-C(50.1%),P<0.01. The concentrations of NGAL and Cys-C in every experiment group were significantly different with the control group (P<0.01). The concentration and positive proportion of the two markers had positive correlation with intoxication degree (P<0.05).The expression level of each AKI marker rised to the peak value in 1d after admission then decreased. NGAL of each group decreased more significantly. The expression level of Cys-C of the gently and midrange groups descended moderately, but of the severity group decreased seriously.Conclusion:Incidence of AKI caused by AOPP is 86.7%. NGAL and Cys-C are early and sensitive markers to diagnose AKI. During AOPP, both the specificity of them are high, which reached 100%,the sensitivity of NGAL is higher than Cys-C.Both of them had positive correlation with intoxication degree.