联合检测血清正五聚蛋白、高迁移率族蛋白1及微小RNA-21对急性肾损伤有预测价值  

Predictive value of serum PTX3, HMGB-1 and miR-21 in acute kidney injury

作　　者：史添立[1] 罗贞[1] 焦石[2] SHI Tian-li;LUO Zhen;JIAO Shi(Department of Nephrology,Haikou People's Hospital,Hainan Haikou 570208,China;Department of Nephrology and Rheumatism,Zhongshan Pok AI Hospital,Guangdong Zhongshan 510603,China)

机构地区：[1]海口市人民医院肾内科,海南海口570208 [2]中山市博爱医院肾病风湿科,广东中山510603

出　　处：《内科急危重症杂志》2023年第4期277-279,共3页Journal of Critical Care In Internal Medicine

基　　金：海南省卫生计生行业科研项目(No:19A200052)。

摘　　要：目的:探讨血清正五聚蛋白(PTX3)、高迁移率族蛋白1(HMGB-1)及微小RNA(miR)-21在急性肾损伤(AKI)中的表达及意义。方法:随机选取87例AKI患者为研究组,并选择同期体检的健康人50例为对照组,参照改善全球肾脏病预后组织分期标准,其中Ⅰ期23例,Ⅱ期33例,Ⅲ期31例,根据预后(住院后28 d内)情况分为死亡组19例和存活组68例。监测患者血清PTX3、HMGB-1及miR-21水平并绘制受试者工作特征(ROC)曲线,计算最佳诊断截断值和曲线下面积(AUC),分析其对AKI的预测价值。结果:研究组患者血清PTX3、HMGB-1水平高于对照组,miR-21水平低于对照组(P均<0.05);Ⅰ期患者血清PTX3、HMGB-1水平低于Ⅱ期、Ⅲ期患者,且Ⅱ期低于Ⅲ期;Ⅰ期患者miR-21水平高于Ⅱ期、Ⅲ期患者,且Ⅱ期高于Ⅲ期(P均<0.05);死亡组患者血清PTX3、HMGB-1水平高于存活组,miR-21水平低于存活组(P均<0.05);PTX3诊断AKI的截断值为13.28 ng/L,AUC为0.833(95%CI:0.771~0.895);HMGB-1诊断AKI的截断值为11.40pg/mL,AUC为0.916(95%CI:0.901~0.935);miR-21诊断AKI的截断值为0.89,AUC为0.895(95%CI:0.842~0.947);3项联合检测诊断AKI的AUC为0.989(95%CI:0.981~0.999),优于各指标单独预测(Z=4.873、8.062、3.479,P均<0.05)。结论:AKI患者血清PTX3、HMGB-1及miR-21水平表达明显异常,联合检测有预测价值。Objective:To study the predictive value of serum pentameric protein(PTX3),high mobility group protein 1(HMGB-1)and miR-21 in acute kidney injury.Methods:Totally,87 patients with acute kidney injury were selected as the study group,and 50 healthy patients who received physical examination in our hospital during the same period were selected as the control group.The changes of serum PTX3,HMGB-1 and miR-21 levels and their predictive value were analyzed.Results:The serum levels of PTX3 and HMGB-1 in the study group were significantly higher than those in the control group,and the levels of Mir-21 were significantly lower than those in the control group(P<0.05).The serum levels of PTX3 and HMGB-1 in stage I acute kidney injury patients were significantly lower than those in acute kidney injury stageⅡandⅢpatients,and the level of Mir-21 was significantly higher in stage I acute kidney injury patients than that in stageⅡandⅢpatients.The serum levels of PTX3 and HMGB-1 in acute kidney injury stageⅡpatients were significantly lower than those in stageⅢpatients,and the level of Mir-21 was significantly higher in stageⅡacute kidney injury patients than that in stageⅢpatients.The difference was significant(P<0.05).The levels of serum PTX3 and HMGB-1 in death group were significantly higher than those in survival group,and the levels of Mir-21 in death group were significantly lower than those in survival group with the differences being significant(P<0.05).The AUC of PTX3 in the diagnosis of acute kidney injury was 0.833 and 95%CI was 0.771-0.895.The AUC of HMGB-1 in the diagnosis of acute kidney injury was 0.916 and 95%CI was 0.901-0.935.The AUC of Mir-21 in the diagnosis of acute kidney injury was 0.895 and 95%CI was 0.842-0.947.The AUC of combined detection for acute kidney injury was 0.989,95%CI was 0.981-0.999,and there was significant difference in AUC area(Z=4.873,8.062,3.479,P<0.05).Conclusion:Serum PTX3,HMGB-1 and miR-21 were significantly abnormal in patients with acute kidney injury,which could be

关 键 词：正五聚蛋白 高迁移率族蛋白1 微小RNA-21 急性肾损伤 预测价值 

分 类 号：R691.6[医药卫生—泌尿科学]