中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (01): 31-35.doi: 10.3969/j.issn.1671-4091.2026.01.007

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血清可溶性白细胞分化抗原14、中性粒细胞明胶酶相关载脂蛋白水平与细菌感染的关系

赵淑丽   白伟伟   庞 博   胡俊杰   杜书同   

  1. 061000 沧州，1沧州市人民医院肾病内科
  • 收稿日期:2025-03-24 修回日期:2025-11-12 出版日期:2026-01-12 发布日期:2025-12-31
  • 通讯作者: 杜书同 E-mail:hbcz19710215@sina.com
  • 基金资助:
    2021年沧州市科技计划自筹经费项目(213106068)

Relationship between serum sCD14 and NGAL levels and bacterial infection in patients undergoing maintenance hemodialysis

ZHAO Shu-li, BAI Wei-wei, PANG Bo, HU Jun-jie, DU Shu-tong   

  1. Department of Nephrology, Cangzhou People's Hospital, Cangzhou 061000, China
  • Received:2025-03-24 Revised:2025-11-12 Online:2026-01-12 Published:2025-12-31
  • Contact: 061000 沧州，1沧州市人民医院肾病内科 E-mail:hbcz19710215@sina.com

摘要： 目的  探究维持性血液透析(maintenance hemodialysis，MHD)患者血清可溶性白细胞分化抗原14(soluble CD14，sCD14)、中性粒细胞明胶酶相关载脂蛋白(neutrophil gelatinase-associated lipocalin，NGAL)水平与细菌感染的关系。 方法  选取沧州市人民医院进行MHD患者为研究组(n=106)，根据有无呼吸道细菌感染分为感染和非感染组，另选106例健康体检者为对照组。ELISA检测sCD14、NGAL水平；并分析其与实验室指标的相关性；采用Logistic回归分析影响因素；分析对MDH患者合并细菌感染的诊断价值。 结果  研究组血清sCD14、NGAL水平高于对照组(t=28.866、7.963，均P＜0.001)。感染组血清sCD14、NGAL水平、红细胞比容(hematocrit，HCT)、降钙素原(procalcitonin，PCT)高于非感染组(t=37.476、8.740、6.086、7.944，均P＜0.001)，白蛋白(albumin，ALB)低于非感染组(t=37.298，P＜0.001)。Pearson分析显示sCD14与NGAL呈正相关(r=0.594，P＜0.001)，血清sCD14、NGAL与HCT(r=0.501、0.512，均P＜0.001)、PCT(r=0.510、0.511，均P＜0.001)呈正相关，与ALB呈负相关(r=0.524、 -0.534，均P＜0.001)。Logistic回归分析显示sCD14(OR=3.148，95%CI：1.590～6.076，P＜0.001)、NGAL(OR=4.378，95%CI：2.011～9.533，P＜0.001)、HCT(OR=2.058，95%CI：1.429～2.963，P＜0.001)、PCT(OR=3.420，95%CI：1.452～8.054，P=0.005)为影响MDH患者合并细菌感染的危险因素，ALB(OR=0.521，95%CI：0.329～0.824，P=0.005)为保护因素。ROC曲线得知血清sCD14、NGAL联合应用的诊断价值优于各自诊断(Z=2.643、2.664，P=0.024、0.021)。 结论  MHD患者血清sCD14、NGAL水平升高，其与细菌感染有关，联合检测其水平变化对患者合并细菌感染有一定的临床价值。

关键词: 维持性血液透析, 细菌感染, 可溶性白细胞分化抗原14, 中性粒细胞明胶酶相关载脂蛋白

Abstract: Objective To investigate the relationship between serum levels of soluble CD14 (sCD14), neutrophil gelatinase-associated lipocalin (NGAL), and bacterial infection in maintenance hemodialysis (MHD) patients.  Methods  MHD patients from Cangzhou People's Hospital were selected as the study group (n=106). Based on the presence or absence of respiratory bacterial infection, they were further divided into an infection group and a non-infection group. Additionally, 106 healthy individuals undergoing physical examinations were selected as the control group. Serum levels of sCD14 and NGAL were measured by ELISA. Their correlations with laboratory parameters were analyzed. Logistic regression was used to identify influencing factors. The diagnostic value of these markers for bacterial infection in MHD patients was analyzed.  Results  Serum levels of sCD14 and NGAL in the study group were higher than those in the control group (t=28.866, 7.963, both P ＜0.001). The infection group had higher serum levels of sCD14, NGAL, hematocrit (HCT), and procalcitonin (PCT) compared to the non-infection group (t=37.476, 8.740, 6.086, 7.944, all P＜0.001), and lower albumin (ALB) levels (t=37.298, P＜0.001). Pearson analysis showed a positive correlation between sCD14 and NGAL (r=0.594, P <0.001). Serum sCD14 and NGAL were positively correlated with HCT (r=0.501, 0.512, both P＜0.001) and PCT (r=0.510, 0.511, both P＜0.001), and negatively correlated with ALB (r=-0.524, -0.534, both P＜0.001). Logistic regression analysis indicated that sCD14 (OR=3.148, 95% CI: 1.590～6.076, P＜0.001), NGAL (OR=4.378, 95% CI: 2.011～9.533, P＜0.001), HCT (OR=2.058, 95% CI: 1.429～2.963, P＜0.001), and PCT (OR=3.420, 95% CI: 1.452～8.054, P=0.005) were risk factors for bacterial infection in MHD patients, while ALB was a protective factor (OR=0.521, 95% CI: 0.329～0.824, P=0.005). ROC curve analysis revealed that the combined application of serum sCD14 and NGAL had higher diagnostic value compared to either marker alone (Z=2.643, 2.664, P=0.024, 0.021).  Conclusion  Serum levels of sCD14 and NGAL are elevated in MHD patients and are associated with bacterial infection. Combined detection of their levels holds clinical value for diagnosing bacterial infection in these patients.

Key words: Maintenance hemodialysis, Bacterial infection, Soluble cluster of differentiation-14, Neutrophil gelatinase-associated lipocalin

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