血清Trx-1在脓毒血症并发急性肾损伤中的表达及其诊断价值  

Expression of serum thioredoxin 1 in sepsis induced acute renalinjury and its diagnostic value

作　　者：樊冰矜 崔莉 张凤芹 张德英 FAN Bingjin;CUI Li;ZHANG Fengqin;ZHANG Deying(Department of Nephrology,Jincheng People's Hospital,Jincheng 048000,Shanxi,China)

机构地区：[1]晋城市人民医院肾内科,山西晋城048000

出　　处：《西部医学》2023年第8期1228-1232,共5页Medical Journal of West China

基　　金：山西省卫生计生委科研课题(201902017)。

摘　　要：目的 探讨血清硫氧还蛋白-1(Trx-1)在脓毒血症并发急性肾损伤(AKI)中的表达及其诊断价值。方法 选取2015年1月—2021年12月我院重症医学科收治入院的脓毒血症患者共216例,根据2012年KDIGO指南关于AKI的诊断和分级标准,85例患者诊断AKI(AKI 1级有38例,AKI 2级有27例,AKI 3级有20例)为AKI组;131例未合并AKI为非AKI组。检测对比两组临床资料血清Trx-1表达水平,采用Logistic回归分析脓毒血症患者并发AKI的危险因素。采用ROC曲线分析联合血清Trx-1对脓毒血症患者并发AKI的诊断价值。结果 脓毒症患者AKI的发生率为39.35%。AKI组血清Trx-1表达水平高于非AKI组,差异具有统计学意义(P<0.05)。血清Trx-1的表达水平与APACHEⅡ、SOFA评分、基线血肌酐(Scr)、乳酸和AKI≥2级的比例呈正相关,与GCS评分和eGFR水平呈负相关(均P<0.05)。Logistic回归分析显示,血肌酐、SOFA评分、低血清白蛋白、血清Trx-1表达水平是脓毒血症患者并发AKI的独立危险因素,ROC曲线提示联合血清Trx-1和Scr对于诊断脓毒血症患者并发AKI具有较高的特异性和敏感性(P<0.05)。结论 血清Trx-1在脓毒血症并发AKI患者中的表达水平高于未并发AKI患者,是脓毒血症并发AKI的独立危险因素,对诊断脓毒血症并发AKI具有较高的诊断价值,可能作为临床诊断脓毒血症并发AKI的生物学标志物。Objective To investigate the expression of serum thioredoxin-1(Trx-1)in sepsis induced acute kidney injury(AKI)and its diagnostic value.Methods A total of 216 patients with sepsis were admitted to the Department of Critical Care from January 2015 to December 2021 in our Hospital.According to the KDIGO guidelines on the diagnosis and grading of AKI in 2012,85 patients were diagnosed with AKI(38 cases of AKI grade 1,27 cases of AKI grade 2,20 cases of AKI grade 3),which was defined as AKI group;131 cases without AKI were diagnosed with non-AKI group.The serum Trx-1 expression level and clinical data of the two groups were detected and compared,and the risk factors of septic patients complicated with AKI were analyzed by logistic regression.ROC curve was used to analyze the diagnostic value of serum Trx-1 in patients with sepsis associated AKI.Results The incidence of AKI in sepsis patients was 39.35%.The expression level of serum Trx-1 in AKI group was higher than that in non-AKI group,and the difference was statistically significant.The expression level of serum Trx-1 was positively correlated with APACHEII,SOFA score,the proportion of baseline serum creatinine(Scr),lactic acid and AKI≥grade 2,and negatively correlated with GCS score and eGFR level.Logistic regression analysis showed that the level of serum Trx-1 was an independent risk factor for septic patients with AKI,and the ROC curve suggested that the level of serum Trx-1 and Scrwere highly specific and sensitive for the diagnosis of septic patients with AKI.Conclusion In patients with sepsis complicated with AKI,the expression level of serum Trx-1 is higher than that in patients without AKI,which is an independent risk factor for AKI in sepsis patients.It has a high diagnostic value for the diagnosis of sepsis induced AKI.It can be used as a biological marker for the diagnosis of sepsis induced AKI.

关 键 词：脓毒症 急性肾损伤 血清硫氧还蛋白-1 临床诊断价值 

分 类 号：R631.2[医药卫生—外科学] R692[医药卫生—临床医学]