脓毒症患者肾损伤程度与血浆血管生成素-1、2水平相关性的研究  

Relationship between the Severity of Kidney Damage and the Levels of Ang-1 and Ang-2 in Patient with Sepsis

作　　者：麦振华[1] 佟琳[1] 钟秀明[1] 邓烈华[1] 姚华国[1] 张媛莉[1] 

机构地区：[1]广东医学院附属医院重症医学科,广东湛江524001

出　　处：《四川医学》2014年第7期757-760,共4页Sichuan Medical Journal

基　　金：广东省医学科研基金(编号:A2009484);湛江市科技攻关计划项目(编号:2013B01038);广东医学院科研基金(编号:M2013028)

摘　　要：目的探讨脓毒症患者肾损伤程度与血浆血管生成素-1、2水平的相关性。方法 96例入住ICU的脓毒症患者,按AKIN急性肾损伤标准分为脓毒症非AKI组(NAKI,n=46),AKIⅠ组(n=23),AKIⅡ组(n=11),AKIⅢ组(n=16),另选取30例健康体检者作为健康对照组(CON,n=30)。登记一般情况并进行急性生理和慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,采血检测血浆Ang-1、Ang-2、血肌酐(Scr),计算肌酐清除率(Ccr),统计分析其相关性。结果①与CON组比较,NAKI、AKIⅠ、AKIⅡ、AKIⅢ组血浆Ang-1水平明显降低(P<0.01),四组间差异无统计学意义(P>0.05);血浆Ang-2水平明显升高(P<0.01),且随AKI分级增高而明显升高(P<0.05)。②各组血浆Ang-1水平与Ccr值无相关(P>0.05),各组血浆Ang-2水平与Ccr值呈正相关(P<0.01),多元回归分析显示Ang-2与Ccr值呈显著独立相关(P<0.01)。③血浆Ang-1水平与APACHEⅡ评分、SOFA评分无相关(P>0.05),血浆Ang-2水平与APACHEⅡ评分、SOFA评分呈正相关(P<0.01),多元回归分析显示Ang-2与APACHEⅡ评分、SOFA评分均呈显著独立相关(P<0.05)。结论血浆Ang-2水平是影响脓毒症患者肾损伤程度的独立危险因素。Objective To investigate the relationship between the severity of kidney damage and the level of Ang-1 and Ang-2 in patients with sepsis. Methods 96 septic patients admitted to ICU were divided into NAKI group （n = 46）,AKIⅠgroup （n = 23）,AKIⅡ group （n = 11）,AKIⅢ group （n = 16） according to different damage degrees under AKIN criteria, and 30 healthy people were also enrolled as healthy control group（n = 30）. The clinical data including the acute physiology and chronic healthy conditions（APACHE） Ⅱ score and sequential organ failure（SOFA） score were collected and recorded. Blood samples were collected to detect plasma Ang-1,Ang-2 , Scr and Ccr and correlation was analyzed. Results ①The plasma Ang-1 levels in NAKI, AKIⅠ, AKIⅡ, AKIⅢ groups were significantly lower compared with CON group （P 〈 0. 01）, but there were no difference among the four groups （P 〉 0. 05）. The plasma Ang-2 levels in NAKI, AKIⅠ,AKIⅡ,AKIⅢ groups were significantly higher compared with CON group （P 〈 0. 01）, and the plasma Ang-2 levels of the four groups significantly increased as their AKI classification increased. ②The plasma Ang-1 level and Ccr was not correlated （P 〉 0. 05）. The plasma Ang-2 level and Ccr was significant correlated （P 〈 0. 01）. Multiple linear regression analysis showed that plasma Ang-2 level was significantly independ-ently correlated with Ccr （P 〈 0. 01）. ③The plasma Ang-1 levels and the APACHEⅡ score and SOFA score were not correlated （P 〉 0. 05）. The plasma Ang-2 levels and the APACHEⅡ score and SOFA score was positively correlated （P 〈 0. 01）. Multiple linear regression analysis showed that plasma Ang-2 level was significantly independently correlated with the APACHEⅡ score and SOFA score （P 〈 0. 05）. Conclusion The plasma Ang-2 level is an independent risk factor associated with severity of kidney damage of septic patients.

关 键 词：血管生成素-1 血管生成素-2 脓毒症 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]