重度烧伤患者入院时尿[TIMP-2]×[IGFBP7]水平与早期肾损伤的关系  

The relationship between the urinary [TIMP-2]×[IGFBP7] level and early renal injury in patients with severe burns

作　　者：杨孟 郭佳 孟祥林[1] YANG Meng;GUO Jia;MENG Xianglin(Department of Critical Care Medicine,The First Affiliated Hospital of Harbin Medical University,Haerbin 150001,China;Department of Anorectal Surgery,The First Affiliated Hospital of Harbin Medical University,Haerbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院重症医学科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院肛肠外科,黑龙江哈尔滨150001

出　　处：《西部医学》2024年第2期228-231,共4页Medical Journal of West China

基　　金：黑龙江省省属高等学校基本科研业务科研项目(2018-KYYWY-0480)。

摘　　要：目的 探讨重度烧伤患者入院时尿组织金属蛋白酶抑制剂-2[TIMP-2]×胰岛素样生长因子结合蛋白7[IGFBP7]水平与早期肾损伤的关系。方法 选取2018年11月—2022年6月本院收治的77例重度烧伤患者设为重度组、77例轻中度烧伤患者设为轻中度组,另选取同期77例体检正常者为正常组。比较3组尿[TIMP-2]×[IGFBP7]水平及血清胱抑素C(CysC)水平。根据重度烧伤患者在住院期间是否发生肾早期损伤分为非肾损伤组(45例)和肾损伤组(32例),比较非肾损伤组、肾损伤组重度烧伤患者尿[TIMP-2]×[IGFBP7]水平及血清CysC水平。分析入院时尿[TIMP-2]×[IGFBP7]、血清CysC对重度烧伤患者并发肾损伤的预测价值。结果 重度组烧伤患者尿[TIMP-2]×[IGFBP7]水平及血清CysC水平高于正常组、轻中度组(P<0.05),轻中度组烧伤患者尿[TIMP-2]×[IGFBP7]水平及血清CysC水平高于正常组(P<0.05)。肾损伤组重度烧伤患者尿[TIMP-2]×[IGFBP7]、血清CysC水平高于非肾损伤组(P<0.05)。入院时尿[TIMP-2]×[IGFBP7]、血清CysC预测重度烧伤患者并发肾损伤的AUC分别为0.873、0.699,截断值分别为1.06 [(ng/mL)^(2)/1000]、5.52 mmol/L,灵敏度分别为84.4%、59.4%,特异度分别为89.9%,73.3%。结论 发生早期肾损伤的重度烧伤患者入院时尿[TIMP-2]×[IGFBP7]水平及血清CysC水平较高,[TIMP-2]×[IGFBP7]水平或可成为预测重度烧伤患者并发肾损伤的潜在指标,为临床评估重度烧伤并发肾损伤提供参考。Objective To investigate the relationship between level of urinary tissue metalloproteinase inhibitor-2(TIMP-2)×insulin-like growth factor-binding protein 7(IGFBP7)and early renal injury in patients with severe burns.Methods From November 2018 to June 2022,77 patients with severe burns and 77 patients with mild and moderate burns who were treated in our hospital were included in the severe group and the mild to moderate group,respectively,and another 77 cases with normal physical examination were regarded as the normal group.Levels of Urine[TIMP-2]×[IGFBP7]and serum cystatin C(CysC)were compared among the three groups.Patients with severe burns were grouped into non-renal injury group(45 cases)and renal injury group(32 cases),according to whether early injury occurred during hospitalization.Levels of urine[TIMP-2]×[IGFBP7]and serum CysC were compared between the non-renal injury group and the renal injury group in severe burn patients.The predictive value of urine[TIMP-2]×[IGFBP7]and serum CysC on admission to severe burn patients complicated with renal injury was analyzed.Results Level of urine[TIMP-2]×[IGFBP7]and serum CysC of burn patients in the severe group were higher than those in the normal group and the mild-to-moderate group(P<0.05),levels of urine[TIMP-2]×[IGFBP7]and serum CysC of burn patients in mild to moderate group were higher than those in normal group(P<0.05).The levels of urinary[TIMP-2]×[IGFBP7]and serum CysC in severe burn patients in the renal injury group were higher than those in the non-renal injury group(P<0.05).The AUC of urine[TIMP-2]×[IGFBP7]and serum CysC on admission to predict renal injury in severe burn patients was 0.873 and 0.699,respectively,and the cut-off value was 1.06[(ng/mL)^(2)/1000]and 5.52 mmol/L,respectively,the sensitivity was 84.4%and 59.4%,respectively,and the specificity was 89.9%and 73.3%,respectively.Conclusion Levels of Urine[TIMP-2]×[IGFBP7]and serum CysC are higher in severe burn patients with early renal injury at admission,and level of[TIMP-2]×[IGF

关 键 词：重度烧伤 组织金属蛋白酶抑制剂-2 早期肾损伤 胰岛素样生长因子结合蛋白7 

分 类 号：R644[医药卫生—外科学]