血清BUN、S-100B蛋白、MBP水平与维持性血液透析患者透析失衡综合征发生风险间的关系及预测价值  

The relationships between serum BUN,S-100B protein,MBP levels and the risk of Dialysis disequilibrium syndrome in maintenance hemodialysis patients and its predictive value

作　　者：郑金花 韦泽丰 王自强 ZHENG Jinhua;WEI Zefeng;WANG Ziqiang(Department of Nephrology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院肾内科,海南海口570102

出　　处：《国际检验医学杂志》2022年第21期2612-2617,共6页International Journal of Laboratory Medicine

基　　金：海南省卫生健康行业科研项目(20A200532)。

摘　　要：目的分析血清尿素氮(BUN)、S-100B蛋白、髓磷脂碱性蛋白(MBP)水平与维持性血液透析(MHD)患者透析失衡综合征(DDS)发生风险间的关系,并探讨三者对DDS的预测价值。方法选取2019年1月至2021年7月该院收治的110例MHD患者为研究对象,采用随机抽样法按7∶3比例分为训练组(77例)和测试组(33例)。统计训练组DDS发生率,比较发生DDS与未发生DDS患者的BUN、S-100B蛋白、MBP水平,采用多因素Logistic回归分析BUN、S-100B蛋白、MBP与MHD患者发生DDS的关系,采用受试者工作特征(ROC)曲线分析BUN、S-100B蛋白、MBP预测MHD患者发生DDS的风险,采用测试组患者BUN、S-100B蛋白、MBP水平对风险模型进行组外验证。结果训练组DDS发生率为15.58%,DDS患者年龄、每周透析次数大于/多于未发生DDS患者,BUN、S-100B蛋白、MBP水平高于未发生DDS患者,血清清蛋白、血红蛋白水平低于未发生DDS患者(P<0.05);BUN、S-100B蛋白、MBP水平升高均会增加DDS发生风险(P<0.05);构建预测MHD患者DDS发生风险的模型为P=1/(1+e^(-Y)),Y=—13.624+1.236×X_(BUN)+1.331×X_(S-100B蛋白)+1.545×X_(MBP),P为发生概率,Y为预测指数,BUN、S-100B蛋白、MBP联合预测DDS的曲线下面积为0.853,风险模型预测测试组DDS发生风险的灵敏度、特异度、准确率分别为80.00%、78.57%、78.78%。结论血清BUN、S-100B蛋白、MBP与MHD患者DDS发生风险密切相关,可用于预测模型的构建,预测DDS发生风险。Objective To analyze the relationships between serum urea nitrogen(BUN),S-100B protein,myelin basic protein(MBP)levels and the risk of Dialysis disequilibrium syndrome(DDS)in patients with maintenance hemodialysis(MHD),and explore the predictive value of the three indicators to DDS.Methods A total of 110 patients with MHD from January 2019 to July 2021 in the First Affiliated Hospital of Hainan Medical College were selected,and they were divided into training group(77 cases)and test group(33 cases)using a random sampling method at a ratio of 7∶3.The incidence of DDS in the training group was statisticed.The levels of BUN,S-100B protein and MBP in patients with or without DDS were compared.Multivariate Logistic regression was used to analyze the relationships between BUN,S-100B protein,MBP and DDS in MHD patients.Receiver operating characteristic(ROC)curve was used to analyze BUN,S-100B protein and MBP to predict the risk of DDS in MHD patients.The BUN,S-100B protein and MBP levels of patients in the test group were used for risk model out-of-group verification.Results The incidence of DDS in the training group was 15.58%.The age of DDS patients was older than that of non-DDS patients,number of dialysis per week of DDS patients was greater than that of non-DDS patients,BUN,S-100B protein and MBP levels of DDS patients were higher than those of non-DDS patients,and serum albumin and hemoglobin levels were lower than those of non-DDS patients(P<0.05).Increased levels of BUN,S-100B protein and MBP would increase the risk of DDS(P<0.05).The risk prediction model was P=1/(1+e^(-Y)),Y=—13.624+1.236×X_(BUN)+1.331×X_(S-100B protein)+1.545×X_(MBP),P was the probability of occurrence and Y was the prediction index.The area under the ROC curve of BUN,S-100B protein and MBP jointly predicted DDS was 0.853.The risk prediction model predicted the sensitivity,specificity and accuracy of the risk of DDS in the test group were 80.00%,78.57%and 78.78%respectively.Conclusion The expression of serum BUN,S-100B protein and MBP

关 键 词：尿素氮 S-100B蛋白 髓磷脂碱性蛋白 维持性血液透析 透析失衡综合征 预测价值 

分 类 号：R587.1[医药卫生—内分泌]