外周血RBP与β2M联合检测对2~4期慢性肾脏病并发急性肾损伤的预警价值  

Early warning value of combined detection of RBP andβ2M in peripheral blood for stage 2-4 chronic kidney disease complicated with acute kidney injury

作　　者：朱清 高勇[1] ZHU Qing;GAO Yong(Department of Nephrology,Huaibei Miners General Hospital,Huaibei 235000,Anhui,China)

机构地区：[1]淮北矿工总医院肾内科,安徽淮北235000

出　　处：《中南医学科学杂志》2023年第2期281-284,共4页Medical Science Journal of Central South China

摘　　要：目的 探讨外周血视黄醇结合蛋白(RBP)与β2微球蛋白(β2M)联合检测对2~4期慢性肾脏病(CKD)并发急性肾损伤(AKI)的预警价值。方法 回顾性分析112例2~4期CKD患者的临床资料,未并发AKI 60例设为非AKI组,并发AKI 52例设为AKI组(Ⅰ期27例、Ⅱ期14例、Ⅲ期11例)。比较非AKI组和AKI组及AKI不同分期患者入组时血清RBP、β2M水平;采用Spearman相关性分析法分析AKI分期与血清RBP、β2M的相关性,以受试者工作特征曲线(ROC)评价RBP、β2M对2~4期CKD并发AKI的预测价值。结果 AKI组血清RBP与β2M水平均高于非AKI组(P<0.05),Ⅲ期血清RBP与β2M高于Ⅱ期,Ⅱ期高于Ⅰ期(P<0.05)。经Spearman相关性分析,RBP与β2M水平与AKI均呈正相关(r=0.712、0.750,P<0.05)。血清RBP与β2M联合预测CKD并发AKI的AUC(95%CI)为0.902(0.831~0.950),高于RBP和β2M的单独预测的0.804(0.719~0.873)、0.817(0.733~0.884)(P<0.05)。结论 血清RBP、β2M是判断2~4期CKD并发AKI的重要指标,且与AKI分期关系密切,联合检测可提高2~4期CKD并发AKI的预测效能,对临床早期识别AKI有重要预警价值。Aim To investigate the early warning value of combined detection of retinol-binding protein(RBP)andβ2-microglobulin(β2M)in peripheral blood for stage 2-4 chronic kidney disease CKD complicated with acute kidney injury(AKI).Methods The clinical data of 112 patients with stage 2-4 CKD were retrospectively analyzed,including 60 patients without AKI as the non-AKI group,and 52 patients with AKI as the AKI group(27 cases in stageⅠ,14 cases in stageⅡ,and 11 cases in stageⅢ).The serum RBP andβ2M levels at the time of enrollment were compared between the non-AKI group and the AKI group and patients with different stages of AKI.The correlation between AKI stage and serum RBP andβ2M was analyzed by Spearman analysis.The predictive value of RBP andβ2M in 2-4 complicated with AKI was evaluated by receiver operating characteristic curve(ROC).Results The levels of serum RBP andβ2M in the AKI group were higher than those in the non-AKI group(P<0.05),and the levels of serum RBP andβ2M in stageⅢwere higher than those in stageⅡ,and those in stageⅡwere higher than those in stage I(P<0.05).According to Spearman correlation analysis,RBP andβ2M levels were significantly positively correlated with AKI analysis(r=0.712,0.750,P<0.05).The AUC(95%CI)of serum RBP combined withβ2M in predicting CKD complicated with AKI was 0.902(0.831-0.950),which was higher than that of RBP andβ2M alone 0.804(0.719-0.873)and 0.817(0.733-0.884)(P<0.05).Conclusion Serum RBP andβ2M are important indexes for judging AKI complicated with CKD in stage 2-4,and they are closely related to the stages of AKI.Combined detection can improve the predictive efficiency of AKI complicated with CKD in stage 2-4,which has important early warning value for early clinical identification of AKI.

关 键 词：2~4期慢性肾脏病 急性肾损伤 视黄醇结合蛋白 β2微球蛋白 预警价值 

分 类 号：R692.6[医药卫生—泌尿科学]