Objective To explore the application value of urinary calprotectin in adult acute kidney injury（AKI） by observing urinary calprotectin concentration in adult AKI patients and healthy people. Methods Fifty patients with AKI（AKI group） and 30 healthy people（healthy control group） were selected to determine the indexes of urinary calprotectin, serum creatinine, blood urea nitrogen, urinary kidney injury molecule-1（KIM-1）, blood albumin and hemoglobin. General clinical data and laboratory indexes were compared between the two groups. ROC curve was used to analyze the predictive value of urinary calprotectin for adult AKI. Results Urinary calprotectin, urinary KIM-1, serum creatinine and blood urea nitrogen were higher in AKI group than in healthy control group（t=10.113, 9.152, 11.119 and 9.049 respectively; P＜0.001）. Urinary calprotectin was positively correlated with serum creatinine（r=0.794, P＜0.001）, urea nitrogen（r=0.462, P=0.001） and urinary KIM-1（r=0.409, P=0.003）, and was negatively correlated with serum albumin（r=-0.620,P=0.042） and hemoglobin（r=-0.289, P＜0.001） in AKI group. When the diagnostic limit of urinary calprotectin for adult AKI was set at 55.17ng/ml, the area under the ROC curve was 0.747（95% CI: 0. 641～0.853）,with the sensitivity of 62.0% and specificity of 90.0%. Conclusion Urinary calprotectin concentration was significantly increased, and was positively correlated with serum creatinine, blood urea nitrogen and urinary KIM-1 levels in adult AKI patients. The sensitivity and specificity of urinary calprotectin for the diagnosis of adult AKI are higher. Therefore, urinary calprotectin has an important clinical value in the prediction and evaluation of therapeutic effect and recovery process in adult AKI patients.

目的 通过观察成人急性肾损伤(acute?kidney?injury,AKI)患者和健康人群中尿钙卫蛋白(calprotectin,CLP)浓度水平,来探究尿CLP对成人AKI的预后评估价值.方法 选择潍坊市人民医院自2020年12月至2021年11月确诊为AKI的患者50例(AKI组)和健康体检中心的健康人群30名(健康对照组),检测两组研究对象的尿CLP、血肌酐、血尿素氮、尿肾损伤因子1(kid-ney?injury?molecule-1,KIM-1)、血白蛋白和血红蛋白等指标,同时收集一般资料,比较两组间上述检测指标的差异性.然后对上述AKI组患者随访90?d后进行分组,行肾脏替代治疗(renal?replace-ment?therapy,RRT)治疗的患者归为透析组,未行RRT治疗的患者归为非透析组;90?d后死亡的患者归为死亡组,未死亡的患者归为存活组,进行相关指标的比较,绘制受试者工作特征曲线(receiv-er?operating?characteristic?curve,ROC)曲线和AKI患者的生存曲线(乘积极限法),评价尿CLP在成人AKI预后中的价值.结果 AKI组患者尿CLP[(65.02?±?33.75)?μg/L比(37.85?±?17.33)?μg/L]、尿KIM-1[(52.21?±?30.91)ng/L比(30.86?±?15.38)ng/L]、血肌酐[(538.62?±?233.91)?μmol/L比(62.03?±14.27)?μmol/L]、血尿素氮[(20.85?±?9.38)?mmol/L比(5.26?±?1.02)?mmol/L]浓度较健康对照组增高.透析组患者的血肌酐[(654.53?±?218.68)?μmol/L比(478.91?±?221.49)?μmol/L]、尿CLP[(92.26?±?29.26)μg/L比(50.99?±?26.82)?μg/L]和尿KIM-1[(65.69?±?40.76)ng/L比(45.27?±?22.04)ng/L]水平较非透析组高,尿CLP预测成人AKI患者进行RRT治疗的诊断界值在76.92?μg/L时,ROC曲线下面积为0.850,敏感度和特异度分别为76.5％和87.9％.死亡组和存活组的尿CLP、血红蛋白、尿KIM-1、血尿素氮、收缩压和舒张压水平比较差异均无统计学意义.尿CLP预测成人AKI患者90?d病死率的曲线下面积为0.564,敏感度和特异度分别为76.5％和87.9％.透析组和非透析组90?d病死率差异无统计学意义(P>0.05).结论 成人AKI患者尿CLP水平较健康对照人群显著升高,尿CLP在预测AKI患者RRT需求方面显示出了一定程度的准确性,但是在预测AKI患者90?d病死率方面表现不佳.

左乙拉西坦是一种广谱抗癫痫药物，主要用于部分性癫痫和全面性癫痫的单药治疗或辅助治疗。报道左乙拉西坦导致低钾血症1例，旨在提供低钾血症的病因分析、诊断、治疗经验，为临床用药安全提供参考。