关键词: 失代偿期肝硬化, 肾损伤, 尿微量白蛋白, 尿β2-微球蛋白, 尿N-乙酰-β-D氨基葡萄糖苷酶, 诊断

Abstract: Objective The aim of this study was to explore the diagnostic efficacy of urine microalbumin (UM-Alb), β2-microglobulin (Uβ2-MG) and N-acetyl-beta-glucosaminidase (NAG-U) levels for renal injury in patients with decompensated liver cirrhosis (LC). Methods A total of 135 patients with decompensated LC cirrhosis were enrolled in our hospital between September 2016 and April 2021. Urine UM-Alb and Uβ2-MG levels were detected by immune scatter turbidity, and NAG-U level was assayed by p-nitrophenol colorimetry. The diagnostic efficacy of urine parameters was evaluated by receiver operating characteristic curve (ROC). Results Out of our series, the renal injury was found based on KDIGO clinical practice guidelines for acute kidney injury in 75 patients (stage I in 41 cases, stage II in 19 cases and stage III in 15 cases); the UM-Alb, Uβ2-MG and NAG-U levels in patients with renal injury were (34.4±10.6) mg/L, (3.4±0.6) mg/L and (14.7±3.6) U/L, all significantly higher than (15.8±4.1) mg/L, (1.1±0.3) mg/L and (9.9±2.7) U/L, respectively, P<0.05] in those without; the UM-Alb, Uβ2-MG and NAG-U levels in patients with renal injury stage III were (49.1±9.3) mg/L, (4.9±0.7) mg/L and (21.9±4.9) U/L, all significantly higher than [(27.9 ±7.6) mg/L, (2.6±0.5) mg/L and (11.2±3.1) U/L, respectively, P<0.05] in patients with renal injury stage I or [(36.8±8.4) mg/L, (3.9±0.4) mg/L and (16.6±3.4) U/L, respectively, P<0.05] in patients with renal injury stage II; the area under the curve (AUC) of UM-Alb, Uβ2-MG and NAG-U combination with the cut-off-value of >26.6 mg/L, >2.5 mg/L and >11.3 U/L, respectively, for diagnosing renal injury was 0.908, significantly greater than 0.793, 0.809 and 0.787 by any one parameter alone (P<0.05), which had a higher sensitivity, specificity and accuracy of 86.7%, 85.0% and 85.9%, respectively. Conclusion The patients with decompensated LC is prone to renal injury, and the detection of UM-Alb, Uβ2-MG and NAG-U levels might help diagnose in time, which warrants further clinical investigation.

Key words: Liver cirrhosis, Renal injury, Urine microalbumin, Urine β2-microglobulin, Urine N-acetyl-beta-glucosaminidase, Diagnosis