感染性休克AKI患者外周血miR-21、miR-29a、Klotho表达和肾脏血流动力学指标水平变化及与预后的关系分析  

Analysis of changes in peripheral blood miR-21,miR-29a,Klotho expression and renal hemodynamic indicators in septic shock AKI

作　　者：蒋强 周楚 Jiang Qiang;Zhou Chu(Shaoyang Central Hospital,Shaoyang,Hunan 422000,China)

机构地区：[1]湖南省邵阳市中心医院,湖南邵阳422000

出　　处：《首都食品与医药》2024年第16期44-47,共4页Capital Food Medicine

摘　　要：目的分析感染性休克急性肾损伤(AKI)患者外周血miR-21,miR-29a,Klotho表达和肾脏血流动力学指标水平变化及与预后的关系.方法选取2021年1月-2023年2月邵阳市中心医院收治的80例感染性休克AKI患者,依据是否死亡分为存活组(58例)与死亡组(22例),依据急性肾损伤(AKI)分期分为AKI 1期组(38例)、2期组(25例)与3期组(17例).比较存活组、死亡组一般资料、miR-21、miR-29a、Klotho水平、急性生理和慢性健康状态评分(APACHEII)及肾脏血流动力学水平,比较不同AKI分组miR-21、miR-29a、Klotho水平、APACHEII评分及肾脏血流动力学水平.结果存活组男性比例、年龄、K+低于死亡组(P<0.05),存活组氧合指数、白细胞计数高于死亡组(P<0.05);存活组miR-21、miR-29a、APACHEII评分、段间动脉搏动指数(PI)、段间动脉阻力指数(RI)及叶间动脉RI低于死亡组(P<0.05),存活组Klotho高于死亡组(P<0.05);AKI分期1期组miR-21、miR-29a、APACHEII评分、段间动脉RI、叶间动脉RI低于2期组和3期组(P<0.05),AKI分期2期组miR-21、miR-29a、APACHEII评分、段间动脉RI、叶间动脉RI低于3期组(P<0.05),AKI分期1期组Klotho高于2期组、3期组(P<0.05),2期组高于3期组(P<0.05);进行Logistic回归分析,分析结果:男性、年龄、K^(+)、miR-21、miR-29a、APACHEII评分、段间动脉RI是AKI患者预后的危险因素(P<0.05),Klotho是AKI患者预后的保护因素.结论感染性休克AKI患者外周血miR-21、miR-29a、Klotho表达和肾脏血流动力学指标水平发生显著变化,miR-21、miR-29a、Klotho、段间动脉RI是AKI患者预后的影响因素.Objective To analyze the changes of miR-21,miR-29a,Klotho expression and renal hemodynamic index in patients with acute kidney injury(AKI).Methods The 80 patients with septic shock AKI admitted to our hospital from January 2021 to February 2023 were divided into survival group(58 cases)and death group(22 cases)according to whether death died,according to the acute kidney injury(AKI)stage into AKI stage 1 group(38 patients),comparing stage 2(25 cases)with stage 3(17 patients),general data,miR-21,miR-29a,Klotho levels,acute physiological and chronic health status score(APACHEII)score and renal hemodynamic level,the levels of miR-21,miR-29a,and Klotho,APACHEII score,and renal hemodynamic level were compared in different AKI groups.Results The proportion of men,age,K+in the surviving group were lower than the dead group(P<0.05),the oxygenation index and white blood cell count of the surviving group were higher than those of the dead group(P<0.05);in the surviving group,miR-21,miR-29a,APACHEII score,intersegment arterial beat index(PI),intersegment arterial resistance index(RI)and interlobar artery RI were lower than those in the death group(P<0.05),the Klotho of the surviving group was higher than that of the dead group(P<0.05);AKI stage 1 group miR-21,miR-29a,APACHEII score,intersegment artery RI,interlobar artery RI were lower than stage 2 group and stage 3 group(P<0.05),the AKI stage 2 group miR-21,miR-29a,APACHEII score,intersegment artery RI and interlobar artery RI were lower than the stage 3 group(P<0.05),the Klotho in AKI stage 1 was higher than that in stage 2 and stage 3(P<0.05),group stage 2 was higher than stage 3 group(P<0.05);performed the Logistic regression analysis,results:Male sex,age,K^(+),miR-21,miR-29a,APACHEII score,and intersegment artery RI were risk factors in patients with AKI(P<0.05),Klotho is a protective factor in AKI patients.Conclusions The peripheral blood miR-21,miR-29a,Klotho expression and renal hemodynamic index levels changed significantly in septic shock AKI,and miR-21,miR-29a,Kl

关 键 词：感染性休克 急性肾损伤 肾脏血流动力学指标 急性生理和慢性健康状态评分 

分 类 号：R631.4[医药卫生—外科学]