血、尿IL-18和KIM-1联合检测对冠心病患者行介入术后急性肾损伤的早期诊断意义

发布时间：2018-04-30 01:18

本文选题：白细胞介素- + 肾损伤分子-　；参考：《南京医科大学学报(自然科学版)》2017年11期

【摘要】：目的:探讨分析血、尿白细胞介素-18(interleukin 18,IL-18)和肾损伤分子-1(kidney injury molecule 1,KIM-1)联合检测在冠心病介入术后急性肾损伤(acute kidney injury,AKI)早期诊断中的价值。方法:选取河南省平顶山市第二人民医院心内科收治的诊断为冠心病并行介入术治疗的患者243例,分为AKI组48例,非AKI组195例;收集所有患者术后0、2、4、6、8、10、12、24、48、72 h血液及尿液样本,检测各时间点血液样本的血清肌酐(serum creatinine,SCr)、IL-18和KIM-1,尿液样本的IL-18和KIM-1水平。结果:AKI组患者术后12、24、48、72 h SCr值均明显高于0 h基线值(P均0.05);AKI组术后各时间点血、尿IL-18和KIM-1水平均高于0 h基线值,IL-18在2 h(血)或4 h(尿)时达到峰值,KIM-1在6 h(血)或8 h(尿)时达到峰值(P均0.05);Pearson相关分析显示,AKI组术后血(2 h)、尿(4 h)IL-18和血(6 h)、尿(8 h)KIM-1水平均与术后24 h SCr呈正相关(P均0.05);ROC曲线分析显示,血(2 h)、尿(4 h)IL-18和血(6 h)、尿(8 h)KIM-1 ROC曲线下面积(AUC)对AKI的诊断均具有较好的诊断效能;血(2 h)、尿(4 h)IL-8和血(6 h)、尿(8 h)KIM-1联合检测诊断AKI的AUC均大于两者的单独检测。结论:对冠心病患者进行介入术后的2 h血IL-18、4 h尿IL-18、6 h血KIM-1、8 h尿KIM-1的联合检测,对早期诊断AKI具有良好的诊断效能,有一定的诊断价值,其或可成为早期诊断AKI的重要参考依据。
[Abstract]:Objective: to investigate the value of serum and urine interleukin-18 (IL-18) and renal injury molecule (-1KIM-1) in the early diagnosis of acute kidney injury-AKI after percutaneous coronary intervention. Methods: a total of 243 patients with coronary heart disease treated in Department of Cardiology, second people's Hospital, Pingdingshan City, Henan Province, were divided into AKI group (n = 48) and non-AKI group (n = 195). Serum creatinine, IL-18 and KIM-1 were measured in blood samples at different time points, and IL-18 and KIM-1 levels in urine samples were measured. Results the SCr values of the patients in the control group were significantly higher than those in the 0 h baseline group (P < 0.05), and were significantly higher than those in the control group (P < 0.05). The levels of IL-18 and KIM-1 in urine were higher than the baseline value at 0 h. The peak value of IL-18 was reached at 2 h (blood) or 4 h (urine). The correlation analysis showed that the levels of IL-18 reached peak value at 6 h (blood) or 8 h (urine) at 6 h or 8 h (urine). There was a positive correlation between the levels of 8 h)KIM-1 and SCr at 24 h after operation (P < 0.05). The results showed that the diagnostic efficiency of AKI was better than that of 2 h, 4 h)IL-18 and 6 h, and the area under the 8 h)KIM-1 ROC curve), and the AUC of the combined detection of AKI was larger than that of the two groups in 2 h, 4 h)IL-8, 6 h, and 8 h)KIM-1 in the urine, and the value of AUC in the diagnosis of AKI was higher than that in the control group (P < 0. 05, P < 0. 05, P < 0. 05), and the AUC of the two groups was higher than that of the control. Conclusion: the combined detection of serum IL-18H and urinary IL-181h urinary KIM-1 in patients with coronary heart disease at 2 h after interventional operation has good diagnostic efficacy and has certain diagnostic value for early diagnosis of AKI. It may be an important reference for early diagnosis of AKI.
【作者单位】：河南省平顶山市第二人民医院心内科;
【分类号】：R541.4;R692.5

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