硒结合蛋白1对急性肾损伤及其危险因素暴露的预警价值  

Early warning value of selenium binding protein 1 on acute kidney injury and its risk factor exposure

作　　者：赵纬昊 段戌尧 崔晨凯 李雨欣 史佳慧 卢家美[1] 陈钊[1] 景兰梅 姚恬 付荣国[1] 田李芳[1] ZHAO Weihao;DUAN Xuyao;CUI Chenkai;LI Yuxin;SHI Jiahui;LU Jiamei;CHEN Zhao;JING Lanmei;YAO Tian;FU Rongguo;TIAN Lifang(Department of Nephrology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710004,P.R.China;Department of Nephrology,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi 710068,P.R.China)

机构地区：[1]西安交通大学第二附属医院肾病内科,西安710004 [2]陕西省人民医院肾病内科,西安710068

出　　处：《华西医学》2024年第7期1056-1062,共7页West China Medical Journal

基　　金：陕西省自然科学基础研究计划面上项目(2023-JC-YB-776,2022JM-479);陕西省科学技术研究与发展计划(社会发展科技攻关项目,2016SF-176);西安交通大学医学“基础-临床”融合创新项目(YXJLRH2022079)。

摘　　要：目的探究尿液硒结合蛋白1(selenium binding protein 1,SBP1)对急性肾损伤(acute kidney injury,AKI)及其危险因素暴露的预警价值,并与尿液中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinaseassociated lipocalin,NGAL)进行比较。方法选择2023年4月-2024年4月西安交通大学第二附属医院肾病内科的成年AKI住院患者及同期该科室的医务工作者。选择2023年6月于西安交通大学第二附属医院心血管内科行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)患者和同期呼吸内科接受包含顺铂的化疗方案抗肿瘤治疗患者。通过酶联免疫吸附法检测纳入患者和医务工作者的尿SBP1及NGAL水平。结果共纳入医务工作者14例,AKI患者36例。除性别、谷丙转氨酶、谷草转氨酶、总胆固醇(P>0.05)外,医务工作者和AKI患者其他指标比较,差异均有统计学意义(P<0.05)。AKI组的尿SBP1[100.30(71.50,138.75)vs.75.60(65.90,80.08)pg/mL;U=2.918,P=0.004]、NGAL[423.70(73.93,839.80)vs.14.80(5.83,29.98)ng/mL;U=4.668,P<0.001]均高于对照组。但尿SBP1受试者工作特征曲线的曲线下面积小于尿NGAL(0.768 vs.0.929)。AKI患者尿SBP1水平与谷丙转氨酶、谷草转氨酶、血肌酐、血糖呈正相关(P<0.05),而与估算肾小球滤过率和总胆固醇呈负相关(P<0.05)。共纳入接受PCI患者14例。接受PCI患者术后6 h的尿SBP1/尿肌酐水平较术前升高[(39.54±8.00)vs.(19.34±2.90)pg/μmol;F=8.862,P=0.011],术后72 h尿素氮水平较术前降低(P=0.036),其余时间点其他指标比较差异均无统计学意义(P>0.05);治疗前后的尿NGAL水平无明显变化。共纳入顺铂治疗患者19例。顺铂治疗患者治疗后尿SBP1水平较治疗前升高(P=0.024),而治疗后尿NGAL水平与治疗前相比无明显变化(P=0.350);治疗后尿素氮(P=0.041)、胱抑素C(P=0.002)水平均较术前升高,而血肌酐、估算肾小球滤过率与治疗前比较,差异均无统计学意义(P>0.05)。结论尿SBP1水�Objective To investigate the early warning value of urinary selenium binding protein 1(SBP1)in acute kidney injury(AKI)and its risk factor exposure,and compare it with urinary neutrophil gelatinase-associated lipocalin(NGAL).Methods Adult AKI inpatients and medical workers from the Department of Nephrology of the Second Affiliated Hospital of Xi'an Jiaotong University between April 2023 and April 2024 were selected.Patients who underwent percutaneous coronary intervention(PCI)in the Department of Cardiology of the Second Affiliated Hospital of Xi'an Jiaotong University were selected in June 2023.Patients who received cisplatin treatment in the Respiratory Department of the Second Affliated Hospital of Xi'an Jiaotong University were selected in June 2023.Urinary SBP1 and NGAL levels of patients and medical workers were detected by enzyme-linked immunosorbent assay.ResultsA total of 14 medical workers and 36 AKI patients were included.Except for gender,alanine aminotransferase,aspartate aminotransferase,total cholesterol(P>0.05),there were statistically significant differences in other indicators between the medical workers and the AKI patients(P<0.05).The urine SBP1[100.30(71.50,138.75)vs.75.60(65.90,80.08)pg/mL;U=2.918,P=0.004]and NGAL[423.70(73.93,839.80)vs.14.80(5.83,29.98)ng/mL;U=4.668,P<0.001]levels in the AKI group were higher than those in the control group.But the area under the curve of receiver operative characteristic curve of urine SBP1 was smaller than that of urine NGAL(0.768 vs.0.929).The urine SBP1 level in AKI patients was positively correlated with alanine aminotransferase,aspartate aminotransferase,serum creatinine,and serum glucose(P<0.05),but negatively correlated with estimated glomerular filtration rate and total cholesterol(P<0.05).A total of 14 patients who underwent PCI were included.The urinary SBP1/creatinine levels of PCI patients increased 6 hours after surgery compared to preoperative levels[(39.54±8.00)vs.(19.34±2.90)pg/μmol;F=8.862,P=0.011].The urea nitrogen level decreased 72 h

关 键 词：硒结合蛋白1 急性肾损伤 危险因素 预警价值 

分 类 号：R692[医药卫生—泌尿科学]