脓毒症并发急性肾损伤患者血清MCP-1、MFG-E8、sCD14-ST的表达及临床意义  

Expression and clinical significance of serum monocyte chemoattractant protein-1,milk fat globule-epidermal growth factor 8,soluble cluster of differentiation 14 subtypes in patients with sepsis complicated with acute kidney injury

作　　者：高君兰 朱丹丹[1] 于健[1] GAO Jun-lan;ZHU Dan-dan;YU Jian(Department of Critical Care,the Second Hospital of Dalian Medical University,Dalian 116027,Liaoning,CHINA)

机构地区：[1]大连医科大学附属第二医院重症医学科,辽宁大连116027

出　　处：《海南医学》2021年第16期2044-2047,共4页Hainan Medical Journal

基　　金：辽宁省自然科学基金(编号:20170540238)。

摘　　要：目的研究脓毒症并发急性肾损伤(AKI)患者血清单核细胞趋化蛋白-1(MCP-1)、乳脂球表皮生长因子8(MFG-E8)、可溶性白细胞分化抗原14亚型(sCD14-ST)的表达水平并探讨其临床意义。方法将2018年1月至2020年10月大连医科大学附属第二医院重症医学科收治的120例脓毒症患者纳入研究,将其按照是否并发AKI分为AKI组57例和非AKI组63例。比较两组患者的临床基线资料和血清MCP-1、MFG-E8、sCD14-ST水平,采用多因素Logistic回归分析明确脓毒症并发AKI与各项因素的关系,并以受试者工作特征(ROC)曲线分析血清MCP-1、MFG-E8、sCD14-ST诊断脓毒症并发AKI的效能。结果AKI组患者的血清MCP-1、sCD14-ST水平分别为(548.32±134.29)ng/mL、(1542.19±245.23)pg/mL,明显高于非AKI组的(346.28±103.56)ng/mL、(551.32±123.49)pg/mL,而MFG-E8水平为(7.62±2.10)pg/mL,明显低于非AKI组的(15.12±2.37)pg/mL,差异均有统计学意义(P<0.05);AKI组患者的高血压病史、肺部感染人数占比明显高于非AKI组,且急性生理与慢性健康状况评估Ⅱ(APACHEⅡ)评分和动脉血乳酸、尿素氮(BUN)、血肌酐(Scr)水平明显高于非AKI组,而氧合指数明显低于非AKI组,差异均有统计学意义(P<0.05);经多因素Logistic回归分析发现,高血压病史、肺部感染、APACHEⅡ评分、动脉血乳酸以及血清MCP-1、sCD14-ST水平均是脓毒症并发AKI的独立危险因素(P<0.05),而血清MFG-E8水平是脓毒症并发AKI的保护性因素(P<0.05);血清MCP-1、MFG-E8、sCD14-ST联合检测诊断脓毒症并发AKI的曲线下面积、灵敏度、特异度、约登指数均高于上述三项指标单独诊断,差异均有统计学意义(P<0.05)。结论脓毒症并发AKI患者均存在血清MCP-1、sCD14-ST明显高表达,而MFG-E8则明显低表达,且联合检测可能为临床脓毒症并发AKI的诊断提供可靠依据。Objective To investigate the expression levels of serum monocyte chemoattractant protein-1(MCP-1),milk fat globule-epidermal growth factor 8(MFG-E8),and soluble cluster of differentiation 14 subtype(sCD14-ST)in patients with sepsis complicated with acute kidney injury(AKI),and to explore their clinical significance.Methods A total of 120 sepsis patients admitted to the Department of Critical Care at the Second Hospital of Da-lian Medical University from January 2018 to October 2020 were included in this study,and they were divided into AKI group(n=57)and non-AKI group(n=63)according to whether they were complicated with AKI.The clinical baseline data and the serum levels of MCP-1,MFG-E8 and sCD14-ST were compared between the two groups.Multivariate Logistic regression analysis was used to determine the relationship between sepsis complicated with AKI and various factors.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum MCP-1,MFG-E8 and SCD14-ST in the diagnosis of sepsis complicated with AKI.Results The serum levels of MCP-1 and sCD14-ST were(548.32±134.29)ng/mL and(1542.19±245.23)pg/mL in the AKI group,respectively,which were significantly higher than corresponding(346.28±103.56)ng/mL and(551.32±123.49)pg/mL in the non-AKI group;while the level of MFG-E8 was(7.62±2.10)pg/mL in the AKI group,which was significantly lower than(15.12±2.37)pg/mL in the non-AKI group;all differences were statistically significant(P<0.05).The proportion of patients with hypertension and pulmonary infection in the AKI group was significantly higher than that in the non-AKI group;the acute physiology and chronic health evaluation(APACHEⅡ)score and the levels of arterial blood lactic acid,blood urea nitrogen(BUN),and serum creatinine(Scr)were significantly higher than those in the non-AKI group;while the oxygenation index was significantly lower than that in the non-AKI group;all differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that history

关 键 词：脓毒症 急性肾损伤 单核细胞趋化蛋白-1 乳脂球表皮生长因子8 可溶性白细胞分化抗原14亚型 诊断 

分 类 号：R631[医药卫生—外科学]