血清LCN2、UMOD及尿IL-18联合检测在重症急性胰腺炎并发急性肾损伤中的早期预测价值  

The Value of Combined Detection of Serum LCN2,UMOD and Urine IL-18 in the Early Prediction of Severe Acute Pancreatitis with Acute Kidney Injury

作　　者：郭馨巍 高明[1] 李贺[1] 程俊[1] 汪海平[1] 孙远松 宋凯 姜大同[1] GUO Xin-wei;GAO Ming;LI He;CHENG Jun;WANG Hai-ping;SUN Yuan-song;SONG Kai;JIANG Da-tong(Department of Emergency Surgery,the Second Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院急诊外科,安徽合肥230601

出　　处：《医学信息》2023年第2期85-91,共7页Journal of Medical Information

基　　金：安徽医科大学校科学研究基金资助项目(编号:2020xkj192)。

摘　　要：目的 探究血清脂质运载蛋白2(LCN2)、尿调节素(UMOD)、尿白细胞介素-18(IL-18)联合检测对重症急性胰腺炎(SAP)并发急性肾损伤(AKI)的早期预测价值。方法 回顾性收集2018年1月-2021年9月入住安徽医科大学第二附属医院的102例SAP患者资料,于入院后7 d内根据有无并发AKI分为无AKI组(SAP组,64例)、并发AKI组(SAP&AKI组,38例),其中SAP&AKI组根据肾损伤严重程度分为Ⅰ组17例、Ⅱ组13例、Ⅲ组8例。比较四组血清LCN2、UMOD、尿IL-18水平,对各指标进行ROC曲线及相关性分析,并以此评判其联合检测对SAP并发AKI的早期预测价值。结果 SAP&AKI各亚组血清LCN2、尿IL-18水平高于SAP组,且随着AKI严重程度的增加而升高(P<0.05);SAP&AKI各亚组血清UMOD水平低于SAP组,且随着AKI严重程度的增加而降低(P<0.05);ROC曲线分析显示,应用平行试验对三者进行联合检测可见SAP&AKIⅠ组、SAP&AKIⅡ、SAP&AKIⅢ的预测灵敏度上升至0.998、0.997、0.998,而应用系列试验对三者进行联合检测可见SAP&AKIⅠ组、SAP&AKIⅡ、SAP&AKIⅢ的预测特异度上升至0.987、0.994、0.996;相关性分析显示,LCN2、IL-18与尿量呈负相关(r=-0.524、-0.637,P<0.05)、UMOD与尿量呈正相关(r=0.596,P<0.05);LCN2、IL-18与肌酐呈正相关(r=0.617、0.553,P<0.05)、UMOD与肌酐呈负相关(r=-0.541,P<0.05)。结论 血清LCN2、UMOD、尿IL-18检测对SAP并发AKI具有预测价值,并且三者联合检测能够提高预测效能。Objective To explore the early predictive value of combined detection of serum lipid carrier protein 2(LCN2), uromodulin(UMOD) and urine interleukin-18(IL-18) in severe acute pancreatitis(SAP) complicated with acute kidney injury(AKI). Methods The data of 102 SAP patients admitted to the Second Hospital of Anhui Medical University from January 2018 to September 2021 were retrospectively collected. Within 7 days after admission, they were divided into non-AKI group(SAP group, 64 cases) and concurrent AKI group(SAP&AKI group, 38 cases) according to the presence or absence of concurrent AKI. The SAP&AKI group was divided into Ⅰ group(17 cases), Ⅱ group(13 cases) and Ⅲ group(8 cases)according to the severity of renal injury. The levels of serum LCN2, UMOD and urinary IL-18 were compared among the four groups. The ROC curve and correlation analysis of each index were performed to evaluate the early predictive value of combined detection for SAP complicated with AKI.Results The levels of serum LCN2 and urinary IL-18 in SAP&AKI subgroups were higher than those in SAP group, and increased with the severity of AKI(P<0.05). The serum UMOD level in SAP&AKI subgroups was lower than that in SAP group, and decreased with the increase of AKI severity(P<0.05). ROC curve analysis showed that the predictive sensitivity of SAP&AKI Ⅰ group, SAP&AKIⅡ group and SAP&AKIⅢ group increased to0.998, 0.997 and 0.998 by parallel test, while the predictive specificity of SAP&AKIⅠ group, SAP&AKIⅡ group and SAP&AKIⅢ group increased to0.987, 0.994 and 0.996 by series test. Correlation analysis showed that LCN2 and IL-18 were negatively correlated with urine volume( r=-0.524,-0.637, P<0.05), and UMOD was positively correlated with urine volume(r=0.596, P<0.05);LCN2 and IL-18 were positively correlated with creatinine(r=0.617, 0.553, P<0.05), and UMOD was negatively correlated with creatinine(r=-0.541, P<0.05).Conclusion The detection of serum LCN2, UMOD,and urine IL-18 has predictive value for severe acute pancreatitis complicat

关 键 词：重症急性胰腺炎 急性肾损伤 血清脂质运载蛋白2 尿调节素 尿白细胞介素-18 

分 类 号：R576[医药卫生—消化系统]