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.%目的：评估尿液中的中性粒细胞明胶酶相关脂质转载蛋白（uNGAL）对重症颅脑外伤患者急性肾损伤（AKI）的预测价值。方法收集该院2011年1月至2013年5月重症监护室（ICU ）收治的重症颅脑外伤患者102例，入住 ICU 后7 d 内符合AKI 诊断标准的43例为 AKI 组，选择年龄、性别、疾病严重程度、手术方式等匹配的43例为非 AKI 组，检测比较两组入住 ICU即刻（15 min 内）、第24、48、72 h uNGAL 和血肌酐（Scr）水平，采用受试者工作曲线（ROC）评价 uNGAL 和 Scr 对 AKI 诊断价值的敏感性和特异性。结果重症颅脑外伤 AKI 发生率为42．16％（43/102）。 AKI 组 uNGAL 水平随着入住 ICU 时间延长而升高，非 AKI 组升高并不明显。入住 ICU 24 h 时，AKI 组 uNGAL 水平（720．32±684．25）ng/mL 明显高于非 AKI 组（421．92±351．20）ng/mL ，差异有统计学意义（P＜0．05），Scr 水平差异无统计意义（P＞0．05）。入住 ICU 24 h 时 uNGAL 和 Scr 的 ROC 曲线下面积分别为0．879（95％ CI ：0．807～0．949）和0．612（95％ CI ：0．493～0．731）。 uNGAL 截取值为180 ng/mL 时，敏感性和特异性分别为0．890 和0．823，敏感性高于 Scr 。结论 uNGAL 早期诊断重症颅脑外伤患者 AKI 的作用优于 Scr ，可以作为早期诊断 AKI 生物标志物。
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