尿液sTREM-1对脓毒症相关急性肾损伤的诊断价值  

Early diagnosis value of urine strem-1 for sepsis-related kidney failure

作　　者：陈兴旺[1] 赖剑波[1] 姚志军[1] 陈少霖[1] 周华锋[1] 庄海燕[1] 熊旭明[2] 

机构地区：[1]广州医科大学附属深圳沙井医院ICU,广东深圳518104 [2]广州医科大学第二附属医院ICU,广东广州510260

出　　处：《中国现代医学杂志》2014年第5期56-60,共5页China Journal of Modern Medicine

基　　金：深圳市宝安区科技计划社会公益科研资助项目(No:2013150)

摘　　要：目的初步评价尿sTREM-1水平对于脓毒症相关AKI患者的早期诊断价值。方法收集广州医科大学附属深圳沙井医院ICU的脓毒症患者共56例,根据是否合并AKI和28 d时的生存情况进行分组。记录患者的性别、年龄和脓毒症情况,测量患者入住重症监护病房时的SCr、尿sTREM-1水平和24 h尿量,并每24 h留取1次标本。绘制ROC曲线分析相关指标对疾病的诊断价值,Logistic回归分析AKI发生的相关危险因素。结果 27例脓毒症患者在入住ICU后48 h时内发生AKI,Sepsis+AKI组患者在脓毒症严重程度、确诊前一天和确诊当天的SCr、尿量及尿sTREM-1水平与Sepsis组的差异有统计学意义(P<0.05)。此外Sepsis+AKI组患者死亡率高于Sepsis组(55.6%VS 17.2%)。在早期诊断脓毒症相关AKI时尿sTREM-1要优于SCr和尿量(0.750 VS 0.732,0.263)。单因素Logistic回归分析显示,脓毒症严重程度、预后、SCr、尿量及尿sTREM-1水平是发生AKI的危险因素,多因素Logistic回归分析显示,只有尿sTREM-1水平是发生AKI的独立危险因素。结论在早期诊断脓毒症相关AKI时尿液sTREM-1水平要优于SCr和尿量;脓毒症严重程度、SCr、尿量及尿sTREM-1水平是AKI发生的危险因素,但是只有尿sTREM-1水平为独立危险因素。[ Objective ] To evaluate the diagnostic value of urine sTREM- 1 for patients with Septic a- cute kidney injury. [Methods] Fifty-six patients with sepsis in intensive care unit of Shenzhen Shajing Hos- pital were enrolled in our study. Groupings were divided according to sepsis-related kidney failure or not and survival situation in 28 days. Sexes, age, severity of sepsis, levels of urine sTREM- 1, SCr and urine output were measured 1 h and following every 24 h after enrolled in our study. Indicators to diagnosis were managed by receiver operating characteristic （ROC）. The risk factors were analyzed by univariate and multivariate logis- tic regression analysis. [Results] There were 27 patients occurred sepsis- related kidney failure during 48 h, the levels of urine sTREM - 1 and SCr at diagnosis and 24 h before were enhanced in sepsis ＋ AKI group,

关 键 词：可溶性髓样细胞触发受体-1 脓毒症 急性肾损伤 

分 类 号：R692[医药卫生—泌尿科学]