肝素结合蛋白对脓毒症患者急性肾损伤的预测价值  

Predictive value of heparin binding protein for acute kidney injury in patients with sepsis

作　　者：朱洪伍 梁继芳[1] 武卫东[1] 闫新明[1] ZHU Hong-Wu;LIANG Ji-Fang;WU Wei-Dong;YAN Xin-Ming(Department of Emergency,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学第三医院·山西白求恩医院·山西医学科学院·同济山西医院急诊科,太原030032

出　　处：《中华老年多器官疾病杂志》2022年第4期266-270,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：山西省重点研发计划项目(201603D321065)。

摘　　要：目的探讨肝素结合蛋白(HBP)对脓毒症患者急性肾损伤(AKI)的预测价值。方法回顾性分析山西医科大学第三医院急诊科于2020年5月至2021年5月收治的70例脓毒症患者的临床资料,根据入院时是否并发AKI分为AKI组(n=41)和非AKI组(n=29),比较2组患者HBP及其他临床资料。采用SPSS 19.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、秩和检验及χ^(2)检验。采用Spearman相关法分析HBP与其他临床资料的相关性;logistic回归分析脓毒症并发AKI的危险因素,绘制受试者工作特征(ROC)曲线,分析脓毒症患者AKI危险因素的预测价值。结果AKI组与非AKI组间HBP[176.24(100.77,255.92)和44.02(23.15,100.92)ng/ml]、SCr[204.50(137.10,363.35)和92.30(70.70,109.25)μmol/L]、APACHEⅡ[(25.22±8.17)和(17.45±5.05)分]、SOFA[(14.63±3.75)和(7.48±3.80)分]、PCT[26.00(14.39,71.03)和3.73(0.63,11.99)ng/L]比较,差异均有统计学意义(均P<0.05)。HBP与SCr、APACHEⅡ、SOFA、PCT(r=0.538、0.341、0.566、0.444,均P<0.05)呈正相关,与eGFR呈负相关(r=-0.546,P<0.001);logistic回归分析显示HBP(OR=1.024,95%CI 1.012~1.036)、SOFA评分(OR=1.581,95%CI 1.294~1.932)均为脓毒症并发AKI的危险因素(P<0.05);ROC曲线分析HBP对脓毒症AKI的发生有预测价值,最佳截断点为79.895,其灵敏度和特异度分别为92.7%和72.4%。结论HBP可作为脓毒症患者发生AKI的有效预测指标。Objective To investigate the predictive value of heparin binding protein(HBP)for acute kidney injury(AKI)in sepsis patients.Methods A retrospective analysis was carried out on 70 sepsis patients admitted to the emergency department of the Third Hospital of Shanxi Medical University from May 2020 to May 2021.According to being complicated with AKI on admission or not,they were divided into AKI group(n=41)and non-AKI group(n=29).HBP level and other clinical data were compared between the 2 groups.SPSS statistics 19.0 was used for statistical analysis.Data comparison between 2 groups was carried out using student′s t test,rank sum test or Chi-square test depending on different data types.Spearman correlation analysis was employed to analyze the correlation between HBP and other clinical data.Logistic regression analysis was adopted to analyze the risk factors for AKI in sepsis patients,and receiver operating characteristic(ROC)curve was drawn to evaluate the predictive values of the risk factors.Results Significant differences were observed between the AKI group and non-AKI group in HBP[176.24(100.77,255.92)vs 44.02(23.15,100.92)ng/ml],serum creatinine(SCr)[204.50(137.10,363.35)vs 92.30(70.70,109.25)μmol/L],acute physiology and chronic health evaluationⅡ(APACHEⅡ)score[(25.22±8.17)vs(17.45±5.05)points],sequential organ failure assessment(SOFA)score[(14.63±3.75)vs(7.48±3.80)points]and procalcitonin[PCT,26.00(14.39,71.03)vs 3.73(0.63,11.99)ng/L](all P<0.05).HBP was positively correlated with SCr,APACHEⅡscore,SOFA score and PCT(r=0.538,0.341,0.566,0.444;all P<0.05),and negative correlated with estimated glomerular filtration rate(eGFR,r=-0.546,P<0.001).Logistic regression analysis showed that both HBP(OR=1.024,95%CI 1.012-1.036)and SOFA score(OR=1.581,95%CI 1.294-1.932)were risk factors for AKI in sepsis patients(P<0.05).ROC analysis indicated that HBP had predictive value for AKI in sepsis patients,with a cut-off value of 79.895,a sensitivity of 92.7%,and a specificity of 72.4%.Conclusion HBP can be regard

关 键 词：肝素结合蛋白 脓毒症 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]