尿液TIMP-2、IGFBP-7在老年急性肾损伤患者中的临床诊断预后价值研究  

Prognostic value of urinary TIMP-2 and IGFBP7 in the clinical diagnosis of elderly patients with acute kidney injury

作　　者：杨云飞[1] 李晓岚[1] 王爱田[1] 赵华灵[1] 付珊珊 张建军[1] 梁静涛[1] YANG Yunfei;LI Xiaolan;WANG Aitian;ZHAO Hualing;FU Shanshan;ZHANG Jianjun;LIANG Jingtao(Intensive Care Unit,Kailuan General Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]开滦总医院重症医学科,河北唐山063000

出　　处：《国际检验医学杂志》2023年第1期49-53,共5页International Journal of Laboratory Medicine

基　　金：河北省医学科研课题计划(20221584)。

摘　　要：目的探究尿液金属蛋白酶组织抑制剂-2(TIMP-2)、胰岛素样生长因子结合蛋白-7(IGFBP-7)预测老年急性肾损伤(AKI)的价值及与预后的关系。方法选取2021年6-10月开滦总医院重症监护病房(ICU)住院的老年患者112例,统计入住ICU 24 h后3 d内AKI的发生情况,将患者分为AKI组、非AKI组,比较两组一般资料、入住ICU 12 h内动脉血氧分压(PaO 2)、动脉血二氧化碳分压(PaCO 2)、天门冬氨酸氨基转移酶(AST)、降钙素原(PCT)、血肌酐(SCr)水平及入住ICU即刻、4、12、24 h尿[TIMP-2]×[IGFBP-7],采用Spearman相关系数模型分析各时间点尿[TIMP-2]×[IGFBP-7]与AKI发生的相关性,通过受试者工作特征(ROC)曲线分析各时间点尿[TIMP-2]×[IGFBP-7]预测AKI发生的价值,以AKI组患者死亡和血液滤过为复合终点事件,运用Cox比例风险回归模型分析各时间点尿[TIMP-2]×[IGFBP-7]与复合终点事件的关联性。结果112例老年患者入住ICU 24 h后AKI发生率为25.89%;AKI组入住ICU 4、12、24 h尿[TIMP-2]×[IGFBP-7]均高于非AKI组,差异有统计学意义(P<0.05);入住ICU 4、12、24 h尿[TIMP-2]×[IGFBP-7]与AKI的发生呈正相关(r=0.312、0.479、0.635,均P<0.05);入住ICU 4、12、24 h尿[TIMP-2]×[IGFBP-7]预测AKI发生的曲线下面积(AUC)分别为0.739(95%CI为0.647~0.817)、0.798(95%CI为0.712~0.868)、0.818(95%CI为0.733~0.884);发生复合终点事件患者入住ICU 4、12、24 h尿[TIMP-2]×[IGFBP-7]均高于未发生复合终点事件患者,差异有统计学意义(P<0.05);入住ICU 4、12、24 h尿[TIMP-2]×[IGFBP-7]均是复合终点事件的发生的影响因素(P<0.05)。结论尿液生物标志物[TIMP-2]×[IGFBP-7]与AKI的发生显著相关,入住ICU 24 h内监测尿[TIMP-2]×[IGFBP-7]有助于预测AKI发生风险,且与发生AKI患者的预后密切相关。Objective To explore the value of urinary biomarkers tissue inhibitor of metalloproteinase-2(TIMP-2)and insulin-like growth factor-binding protein-7(IGFBP7)in predicting acute kidney injury(AKI)in the elderly and their relationship with prognosis.Methods A total of 112 elderly patients who were hospitalized in the Intensive Care Unit(ICU)of Kailuan General Hospital from June to October 2021 were selected,and the incidence of AKI within 3 days after 24 hours of ICU admission was counted,and the patients were divided into AKI group and non-AKI group.The general data,arterial oxygen partial pressure(PaO 2),arterial carbon dioxide partial pressure(PaCO 2),aspartate aminotransferase(AST),procalcitonin(PCT),and serum creatinine(SCr)levels within 12 hours of ICU admission and urinary[TIMP-2]×[IGFBP-7]immediately after admission to ICU,4 h,12 h,and 24 h in two groups were compared.Spearman correlation coefficient model was used to analyze the correlation between urinary[TIMP-2]×[IGFBP-7]and the occurrence of AKI at each time point.Receiver operating characteristic(ROC)curve was used to analyze the value of urine[TIMP-2]×[IGFBP-7]in predicting the occurrence of AKI at each time point.The death and hemofiltration of patients in the AKI group were used as composite end points,Cox proportional hazards regression model was used to analyze the association between urine[TIMP-2]×[IGFBP-7]and composite endpoint events at each time point.Results The incidence of AKI in 112 elderly patients admitted to ICU was 25.89%after being admitted to ICU for 24 hours.The urinary[TIMP-2]×[IGFBP-7]in the AKI group was higher than that in the non-AKI group at 4 hours,12 hours and 24 hours after being admitted to the ICU,and the difference was statistically significant(P<0.05).[TIMP-2]×[IGFBP-7]at 4 hours,12 hours and 24 hours after being admitted to the ICU was positively correlated with the occurrence of AKI(r=0.312,0.479,0.635,all P<0.05).The area under the curve(AUC)of[TIMP-2]×[IGFBP-7]at 4 hours,12 hours and 24 hours after being admit

关 键 词：急性肾损伤 老年 金属蛋白酶组织抑制剂-2 胰岛素样生长因子结合蛋白-7 预测 

分 类 号：R692.5[医药卫生—泌尿科学]