脓毒症患者血清胱抑素C、尿液肾脏损伤分子1水平变化及其对并发急性肾损伤的诊断价值

发布时间：2018-04-17 09:13

本文选题：脓毒症 + 急性肾损伤　；参考：《山东医药》2017年31期

【摘要】：目的观察脓毒症患者血清胱抑素C(Cys C)、尿液肾脏损伤分子1(KIM-1)水平变化,并探讨其对并发急性肾损伤(AKI)的诊断价值。方法脓毒症患者65例(脓毒症组,根据是否并发AKI又分为AKI组30例和非AKI组35例),另选20例健康体检者作对照(健康组)。采用生化仪检测血清Cys C、血清肌酐(SCr),ELISA法检测KIM-1;Pearson相关分析法分析各指标的相关性;运用受试者工作特征(ROC)曲线分析Cys C、KIM-1对预测脓毒症并发AKI的灵敏度、特异度。结果与对照组比较,脓毒症组血清Cys C、尿液KIM-1水平升高(P均0.05);与非AKI组比较,AKI组入院2、24、48 h血清Cys C水平及入院6、24、48 h尿液KIM-1水平和入院24、48 h血清SCr水平升高(P均0.05);AKI组入院2 h血清Cys C、入院6 h尿液KIM-1与入院24 h血清SCr均呈正相关(r=0.912、0.899,P均0.05);血清Cys C诊断脓毒症并发AKI的ROC曲线下面积(AUC)为0.776(95%CI 0.659~0.893),以1.86 mg/L为截断值时,其灵敏度为86.67%,特异度为68.61%;尿液KIM-1的AUC为0.879(95%CI0.786~0.971),以30.20 pg/mL为截断值时,其灵敏度为89.99%,特异度为85.71%。结论脓毒症患者血清Cys C、尿液KIM-1水平升高,检测两指标有助于脓毒症诊断及判断是否并发AKI。
[Abstract]:Objective to observe the changes of serum cystatin (C(Cys) and urinary renal injury molecule (KIM-1) levels in patients with sepsis, and to evaluate the diagnostic value of serum cystatin (C(Cys) and urinary renal injury molecule (KIM-1) in patients with acute renal injury.Methods Sixty-five patients with sepsis (sepsis group) were divided into AKI group (30 cases) and non- group (35 cases) according to whether they were complicated with AKI.Serum Cys C was detected by biochemical instrument, serum creatinine was detected by Elisa for KIM-1 Pearson correlation analysis, and the sensitivity and specificity of Cys Con KIM-1 in predicting AKI in sepsis were analyzed by using the operating characteristics of the subjects.Results compared with the control group,In sepsis group, the serum Cys C and urine KIM-1 level were increased (P < 0.05), the serum Cys C level was significantly higher than that in the non- group (P < 0.05), the serum Cys C level was significantly higher than that in the control group (P < 0.05), and the serum Cys C level was significantly higher than that in the control group (P < 0.05). The serum Cys C level was significantly higher than that in the control group (P < 0.05), and the serum Cys C level was significantly higher than that in the control group (P < 0.05).There was a positive correlation between urine KIM-1 at 6 h after admission and serum SCr at 24 h after admission. The area under ROC curve of serum Cys C in the diagnosis of sepsis complicated with AKI was 0. 659 ~ 0. 893%, when 1.86 mg/L was used as truncation value, the area under ROC curve of serum Cys C in diagnosis of sepsis was 0. 659 ~ 0. 893, and the mean value of 0. 86 mg/L was 0. 86 mg/L (P < 0. 05).The sensitivity was 86.67 and the specificity was 68.61, and the AUC of urine KIM-1 was 0.87995 CI 0.786U 0.9710.The sensitivity was 89.9999 and the specificity was 85.71when 30.20 pg/mL was used as the truncation value.Conclusion the levels of serum Cys C and urine KIM-1 in patients with sepsis are increased.
【作者单位】：南通大学附属医院;南通大学;
【分类号】：R459.7;R692

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