脓毒症患者KIM-1、EOT-3、CXCL10水平与急性肾损伤的相关性探究  

Correlation between KIM-1,EOT-3,CXCL10 Levels and Acute Kidney Injury in Patients with Sepsis

作　　者：李敏[1] 马才林[1] 石志祥[1] LI Min;MA Cai-lin;SHI Zhi-xiang(Department of Critical Medicine,the Second People's Hospital of Taizhou City,Taizhou,Jiangsu 225500,China)

机构地区：[1]泰州市第二人民医院重症医学科,江苏泰州225500

出　　处：《解放军医药杂志》2022年第8期46-50,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：江苏省医学会/康缘药业临床医学科研专项基金(2015JZKY02)。

摘　　要：目的探究脓毒症患者肾损伤分子-1(KIM-1)、嗜酸性粒细胞趋化因子-3(EOT-3)、CXC趋化因子配体10(CXCL10)水平与急性肾损伤的相关性。方法选取2018年5月-2021年6月收治的190例脓毒症,根据有无合并急性肾损伤分为观察组90例(急性肾损伤)和对照组100例(无急性肾损伤)。比较2组临床资料及KIM-1、EOT-3、CXCL10、血肌酐(SCr)、尿素(BUN)水平,分析脓毒症患者并发急性肾损伤的影响因素及脓毒症并发急性肾损伤患者KIM-1、EOT-3、CXCL10水平与SCr、BUN的相关性,比较不同预后脓毒症并发急性肾损伤患者入院当日及入院第3、7日KIM-1、EOT-3、CXCL10水平,绘制受试者工作特征(ROC)曲线评价KIM-1、EOT-3、CXCL10水平对脓毒症并发急性肾损伤患者预后的预测价值。结果观察组SCr、BUN、KIM-1、EOT-3、CXCL10水平均高于对照组(P<0.01)。多因素Logistic回归分析显示SCr、BUN、KIM-1、EOT-3、CXCL10为脓毒症患者并发急性肾损伤的独立危险因素(P<0.01)。经Pearson相关性模型分析可知,脓毒症并发急性肾损伤患者KIM-1、EOT-3、CXCL10与肾功能指标SCr、BUN均呈正相关(P<0.01)。脓毒症并发急性肾损伤病死患者入院第3、7日KIM-1、EOT-3、CXCL10水平高于生存患者(P<0.05,P<0.01)。ROC曲线分析显示,KIM-1、EOT-3、CXCL10预测脓毒症并发急性肾损伤患者预后的曲线下面积(AUC)分别为0.770、0.633、0.743,联合预测的AUC为0.891,较各指标单独预测明显升高。结论脓毒症患者KIM-1、EOT-3、CXCL10水平升高与合并急性肾损伤有关,临床监测KIM-1、EOT-3、CXCL10水平可指导治疗方案制定,有助于改善患者预后。Objective To investigate the correlation between the levels of renal injury molecule-1(KIM-1),eosinophil chemokine-3(EOT-3),and CXC chemokine ligand 10(CXCL10)in patients with sepsis and acute kidney injury(AKI).Methods A total of 190 patients with sepsis who were admitted from May 2018 to June 2021 were selected and divided into an observation group of 90 cases(with AKI)and a control group of 100 cases(without AKI)according to the presence or absence of AKI.The clinical data and KIM-1,EOT-3,CXCL10,serum creatinine(SCr),and blood urea nirogen(BUN)levels were compared between the two groups,and the influencing factors of AKI in patients with sepsis and the correlation of KIM-1,EOT-3 and CXCL10 levels with SCr and BUN in patients with sepsis complicated with AKI were analyzed.The KIM-1,EOT-3 and CXCL10 levels on the day of admission and at 3 and 7 d after admission were compared in patients with sepsis complicated with AKI having different prognosis.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of KIM-1,EOT-3 and CXCL10 levels in prognosis of patients with sepsis complicated with AKI.Results The levels of SCr,BUN,KIM-1,EOT-3 and CXCL10 in the observation group were higher than those in the control group(P<0.01).Multivariate Logistic regression analysis showed that SCr,BUN,KIM-1,EOT-3,and CXCL10 were independent risk factors for AKI in patients with sepsis(P<0.01).The Pearson correlation model analysis showed that KIM-1,EOT-3 and CXCL10 were positively correlated with renal function indexes SCr and BUN in patients with sepsis complicated with AKI(P<0.01).The levels of KIM-1,EOT-3 and CXCL10 in patients with sepsis complicated with AKI were higher than those in survival patients at 3 and 7 d after admission(P<0.05,P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)of KIM-1,EOT-3,and CXCL10 for predicting the prognosis of patients with sepsis complicated with AKI were 0.770,0.633,and 0.743,respectively.The AUC of combined detection of the three was 0.891,whi

关 键 词：脓毒症 急性肾损伤 肾损伤分子-1 嗜酸性粒细胞趋化因子-3 CXC趋化因子配体10 相关性 

分 类 号：R631[医药卫生—外科学]