NGAL、KIM-1、Th17细胞检测对脓毒症AKI患者预后的评估  

Evaluation of NGAL,KIM-1 combined with peripheral blood Th17 cell detection on the prognosis of patients with sepsis and AKI

作　　者：杨火保[1] 刘进生[2] 郑彩罚 YANG Huobao;LIU Jinsheng;ZHENG Caifa(Department of Critical Care,Fujian Medical University Provincial School of Clinical Medicine/Fujian Pro-vincial Hospital,Fuzhou,Fujian,China,350001;Gastrointestinal Surgery,Fujian Medical University Pro-vincial School of Clinical Medicine/Established Provincial Hospital,Fuzhou,Fujian,China,350001)

机构地区：[1]福建医科大学省立临床医学院/福建省立医院重症医学科,福建福州350001 [2]福建医科大学省立临床医学院/福建省立医院胃肠外科,福建福州350001

出　　处：《分子诊断与治疗杂志》2021年第9期1529-1532,共4页Journal of Molecular Diagnostics and Therapy

基　　金：福建省自然科学基金面上项目(2019J01123)。

摘　　要：目的分析中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿肾损伤分子-1(KIM-1)联合外周血Th17细胞检测对脓毒症急性肾损伤(AKI)患者经连续性肾脏代替(CRRT)治疗预后的评估价值。方法选取2019年1月至2020年3月在本院行CRRT治疗的69例脓毒症AKI患者设为AKI组,另选取本院同期68例行CRRT治疗的单纯AKI患者作为对照组。将AKI组患者根据病情进行分组,以APACHEⅡ评价:轻度组28例、中度组19例、重度组22例。比较各组NGAL、KIM-1、Th17水平,绘制ROC曲线分析NGAL、KIM-1联合外周血Th17细胞检测对脓毒症AKI者经CRRT治疗预后评估价值。结果 AKI组NGAL、KIM-1、Th17水平明显高于对照组,差异均有统计学意义(P<0.05)。NGAL、KIM-1、Th17在不同病情程度脓毒症AKI患者中表达情况均为:重度组>中度组>轻度组,差异均有统计学意义(P<0.05)。69例患者30 d后死亡17例,存活52例,死亡组脓毒症AKI者NGAL、KIM-1、Th17水平明显高于存活组,差异均有统计学意义(P<0.05)。ROC结果显示,NGAL+KIM-1+Th17评估脓毒症AKI者预后时AUC为0.829,明显高于三者单独检测(P<0.05)。结论 NGAL、KIM-1、外周血Th17细胞水平变化与脓毒症AKI患者病情变化密切相关,三者联合检测可进一步提高对脓毒症AKI患者经CRRT治疗短期预后的预测能力。Objective To analyze the value of neutrophil gelatinase associated lipocalin(NGAL),kidney injury molecule-1(KIM-1) combined with peripheral blood Th17 cell detection in assessing the prognosis of patients with acute kidney injury(AKI) caused by sepsis after continuous renal replacement treatment(CRRT).Methods 69 patients with AKI caused by sepsis who were treated with CRRT in this hospital from January 2019 to March 2020 were collected and set as the observation group.In addition,68 patients with pure AIK treated with CRRT in this hospital during the same period were selected as the control group.The patients in the AKI group were divided into groups according to the severity of the disease,and evaluated by the Acute Physiology and Chronic Health Status Score(APACHE Ⅱ):28 cases in the mild group,19 cases in the moderate group,and 22 in the severe group.The levels of NGAL,KIM-1,and Th17 in different groups were compared,and the ROC curve was drawn to analyze the value of NGAL and KIM-1 combined with peripheral blood Th17 cell detection in assessing the prognosis of patients with AKI of sepsis after CRRT treatment.Results The levels of NGAL,KIM-1,and Th17 in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The expressions of NGAL,KIM-1 and Th17 in patients with AKI caused by sepsis whose severity was different were all as follows:the severe group> the moderate group> the mild group(P<0.05).Seventeen of 69 patients died 30 days later,and 52 survived.The levels of NGAL,KIM-1 and Th17 in septic AKI patients in the death group were significantly higher than those in the survival group,and the differences were statistically significant(P<0.05).ROC results showed that when NGAL+KIM-1+Th17 assessed the prognosis of septic AKI patients,the AUC was 0.829,which was significantly higher than the three separate tests(P<0.05).Conclusion Changes in the levels of NGAL,KIM-1,and peripheral blood Th17 cells are closely related to changes in

关 键 词：NGAL KIM-1 TH17 脓毒症急性肾损伤 CRRT 

分 类 号：R459.7[医药卫生—急诊医学]