组织抑制剂金属蛋白酶-2联合胰岛素样生长因子结合蛋白-7对危重患者急性肾损伤的预测价值  

Predictive value of TIMP-2 combined with IGFBP-7 for acute kidney injury in critically patients

作　　者：李倩琴 郑少忆[1] 徐榕呤 林雪峰[1] 肖泽周 朱鹏 王睿苓 LI Qianqin;ZHENG Shaoyi;XU Rongning;LIN Xuefeng;XIAO Zezhou;ZHU Peng;WANG Ruiling(Department of the Cardiovascular Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院心血管外科,广东广州510515

出　　处：《分子影像学杂志》2019年第2期227-233,共7页Journal of Molecular Imaging

基　　金：广州科技规划项目(201804010067)

摘　　要：目的总结组织抑制剂金属蛋白酶(TIMP)-2联合胰岛素样生长因子结合蛋白(IGFBP)-7对于急性肾损伤AKI患者的预测效能。方法在MEDLINE,EMBASE,Web of Science,Clinical Trials.gov,Cochrane Library,Google Scholar进行检索,筛选出13篇相关研究,使用STATA version17.0及R version3.2.2进行统计分析,根据不同的折点计算合并敏感性、合并特异性及95%可信区间。计算合并的曲线下面积及置信区间。结果 [TIMP-2]×[IGFBP-7]对于急性肾损伤预测效能总的合并曲线下面积为0.84(95%CI, 0.78-0.90);非手术组为0.76(95%CI, 0.68-0.84);手术组曲线下面积为0.84(95%CI, 0.81-0.88);德国亚组为(95%CI, 0.79-0.83);美国亚组为0.82(95%CI, 0.79-0.95)。当折点为0.3,[TIMP-2]×[IGFBP-7]对于急性肾损伤预测的敏感性为86%,特异性为57%;当折点为2.0,[TIMP-2]×[IGFBP-7]预测的敏感性为37%,特异性为91%。结论对于包括术后患者在内的重症患者,TIMP-2联合IGFBP-7具有较理想的曲线下面积、敏感性及特异性。Objective To explore the prediction efficiency of TIMP-2 combined with IGFBP-7 for the early prediction ofAKI in critical patients.Methods A comprehensive systemic search was carried out in MEDLINE,EMBASE,Web of Science,Clinical Trials.gov,Cochrane Library,Google Scholar,and 13 related studies were screened.The bivariate generalized nonlinear mixedeffect model and the hierarchical summary receiver operating characteristic model were used to estimate the pooled sensitivity,specificity,and summary receiver operating characteristic curve of TIMP-2 plus insulin-like growth factor-binding protein(IGFBP)-7.Results The pooled area under the curve (AUC) of [TIMP-2]×[IGFBP-7] for predicting AKI was 0.84(95% CI,0.78-0.90).A hierarchical bivariate generalized linear model with a cutoff of 0.3 indicated a sensitivity of 86% and specificity of 57%;with a cutoff of 2.0 indicating sensitivity of 37% and the specificity of 91%.Conclusion TIMP-2 combined with IGFBP- 7 have effective AUC,sensitivity and specificity to predict AKI for the postoperative patients and critical patients.

关 键 词：急性肾损伤 组织抑制剂金属蛋白酶-2 胰岛素样生长因子结合蛋白-7 心脏手术 重症患者 

分 类 号：R459.7[医药卫生—急诊医学] R692.5[医药卫生—治疗学]