血清sFlt-1、VASP水平对重症急性胰腺炎并发急性肾损伤的预测价值  

Predictive value of serum sFlt-1 and VASP levels for acute kidney injury with severe acute pancreatitis

作　　者：周小安[1] 陈阿红[1] 盛秀红 花睿 李慧 ZHOU Xiaoan;CHEN Ahong;SHENG Xiuhong;HUA Rui;LI Hui(Department of Clinical Laboratory,Taizhou Hospital of Traditional Chinese Medicine,Taizhou,Jiangsu 225399,China)

机构地区：[1]江苏省泰州市中医院检验科,江苏泰州225399

出　　处：《检验医学与临床》2024年第5期603-607,共5页Laboratory Medicine and Clinic

基　　金：江苏省卫生健康委员会科研课题(BJ19037)。

摘　　要：目的 研究血清可溶性血管内皮生长因子受体1(sFlt-1)、血管扩张刺激磷蛋白(VASP)对重症急性胰腺炎(SAP)患者并发急性肾损伤(AKI)的预测价值。方法 选取2015年2月至2021年2月该院诊治的198例SAP患者作为SAP组。根据SAP患者是否发生AKI分为AKI组(42例)和非AKI组(156例),根据AKI的严重程度将AKI组分为Ⅰ~Ⅲ期。另选取同期于该院体检中心体检的100例健康人作为对照组。采用酶联免疫吸附试验检测血清sFlt-1、VASP水平。采用多因素Logistic回归分析SAP并发AKI的影响因素。采用受试者工作特征曲线评估血清sFlt-1、VASP对SAP并发AKI的预测价值。结果 SAP组血清sFlt-1、VASP水平均高于对照组,差异均有统计学意义(P<0.05)。不同AKI分期患者血清sFlt-1、VASP水平均为Ⅲ期>Ⅱ期>Ⅰ期,且不同分期间两两比较差异均有统计学意义(P<0.05)。AKI组血淀粉酶、血清sFlt-1、VASP水平均明显高于非AKI组,血尿素氮/血肌酐比值低于非AKI组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血淀粉酶升高、血清sFlt-1升高、VASP升高是SAP并发AKI的独立危险因素(P<0.05),血尿素氮/肌酐比值升高是SAP并发AKI的保护因素(P<0.05)。血清sFlt-1、VASP联合预测SAP并发AKI的曲线下面积(AUC)为0.868,大于血清sFlt-1、VASP单独检测的0.812、0.784,差异均有统计学意义(Z=3.348、3.847,P<0.05)。血清sFlt-1、VASP联合检测预测SAP并发AKI的灵敏度为0.826,特异度为0.755。结论 SAP并发AKI患者血清sFlt-1、VASP水平升高是SAP并发AKI的独立危险因素,2项指标联合检测对SAP并发AKI具有较高的预测价值。Objective To investigate the predictive value of serum soluble vascular endothelial growth factor receptor-1(sFlt-1) and vasodilator-stimulated phosphoprotein(VASP) for acute kidney injury(AKI) in patients with severe acute pancreatitis(SAP).Methods A total of 198 patients with SAP diagnosed and treated in the hospital from February 2015 to February 2021 were selected as the SAP group.According to whether AKI occurred in SAP patients,they were divided into AKI group(42 cases) and non-AKI group(156 cases),according to the severity of AKI,AKI group was divided into Ⅰ-Ⅲ stages.Another 100 healthy people who underwent physical examination in the same period were selected as the control group.The serum levels of sFlt-1 and VASP were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the risk factors of SAP complicated with AKI.Receiver operating characteristic curve was used to evaluate the predictive value of serum sFlt-1 and VASP for SAP complicated with AKI.Results The serum levels of sFlt-1 and VASP in SAP group were significantly higher than those in control group(P<0.05).The levels of serum sFlt-1 and VASP in patients with different AKI stages were stage Ⅲ> stage Ⅱ> stage Ⅰ,and the differences were statistically significant between any two groups(P<0.05).The levels of serum amylase,serum sFlt-1 and VASP in AKI group were significantly higher than those in non-AKI group,and the ratio of blood urea nitrogen to serum creatinine was lower than that in non-AKI group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased serum amylase,serum sFlt-1,and VASP were independent risk factors for SAP complicated with AKI(P<0.05),and increased blood urea nitrogen/creatinine ratio was a protective factor for SAP complicated with AKI(P<0.05).The area under the curve(AUC) of serum sFlt-1 and VASP combined to predict SAP complicated with AKI was 0.868,which was higher than 0.812 and 0.784 of serum sFlt-1 a

关 键 词：重症急性胰腺炎 急性肾损伤 可溶性血管内皮生长因子受体1 血管扩张刺激磷蛋白 预测价值 

分 类 号：R576[医药卫生—消化系统]