尿KIM-1和TIMP-2水平在脓毒症患儿并发急性肾损伤中的预测价值  

The predictive value of urinary KIM-1 and TIMP-2 levels in children with sepsis complicated with acute kidney injury

作　　者：高刘炯 李小磊 宁文慧 苏军[1] 金志鹏[1] GAO Liujiong;LI Xiaolei;NING Wenhui;SU Jun;JIN Zhipeng(Medical Intensive Care Unit,Children’s Hospital Affiliated of Zhengzhou University,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院内科监护室,河南郑州450018

出　　处：《健康研究》2022年第5期563-566,570,共5页Health Research

基　　金：河南省2018年科技发展计划(182102310427);河南省2018年医学科技攻关计划(联合共建项目)(2018020615)。

摘　　要：目的 探讨尿KIM-1和TIMP-2水平在脓毒症并发急性肾损伤(cute kidney injury,AKI)患儿中的预测价值。方法 收集106例脓毒症患儿,并根据临床诊断将其分为AKI组(34例)和非AKI组(72例)。收集患儿的临床及实验室血清学指标,采用酶联免疫吸附法检测各组患儿尿KIM-1和TIMP-2水平。应用ROC曲线分析血清肌酐(Scr)和尿KIM-1、TIMP-2水平对AKI的诊断性能,采用Logistic回归分析脓毒症患儿并发AKI的独立影响因素。结果 与非AKI组相比,AKI组Scr、尿KIM-1、TIMP-2水平均明显升高,差异有统计学意义(P<0.05),且尿KIM-1及TIMP-2水平是脓毒症患儿发生AKI的独立影响因素(P<0.05)。Scr、尿KIM-1和TIMP-2水平诊断AKI的曲线下面积分别为0.741、0.896、0.869,最佳截断值分别为64.77μmol/L、97.60 ng/L、3.80 ng/L。结论 尿KIM-1和TIMP-2水平,对脓毒症患儿并发AKI具有较高的预测价值。Objective To explore the predictive value of urinary KIM-1 and TIMP-2 levels in pediatric patients with sepsis complicated with acute kidney injury(AKI).Methods A total of 106 children with sepsis were collected and divided into AKI group(n=34) and non-AKI group(n=72).The clinical and laboratory serological indexes of children were collected,and the urinary KIM-1 and TIMP-2 levels of children in each group were detected by enzyme-linked immunosorbent assay.ROC curve was used to analyze the diagnostic performance of serum creatinine(Scr) and urinary KIM-1,TIMP-2 levels for AKI.Logistic regression was used to analyze the independent influencing factors of AKI in children with sepsis.Results Compared with the non-AKI group,the levels of Scr,urinary KIM-1 and TIMP-2 levels in the AKI group were significantly higher.The difference was statistically significant(P<0.05).The levels of urinary KIM-1 and TIMP-2 were independent influencing factors of AKI in children with sepsis(P<0.05).The areas under the curve of Scr,urinary KIM-1 and TIMP-2 levels for the diagnosis of AKI were 0.741,0.896 and 0.869,respectively,and the optimal cut-off values were 64.77 μmol/L,97.60 ng/L and 3.80 ng/L,respectively.Conclusions Urinary KIM-1 and TIMP-2 levels have high predictive value for AKI in children with sepsis.

关 键 词：脓毒症 急性肾损伤 肾损伤分子-1 基质金属蛋白酶组织抑制剂-2 

分 类 号：R631[医药卫生—外科学]