尿素、KIM-1及尿酸水平对肾移植术后发生肾功能延迟恢复的预测价值  

Predictive value of levels of urea,KIM-1 and uric acid for occurrence of delayed graft function following kidney transplantation

作　　者：卢志贤[1] 史佳佳[1] 李冰玉[1] 索敬钧 李鹭 Lu Zhixian;Shi Jiajia;Li Bingyu;Suo Jingjun;Li Lu(Department of Kidney Fransplantation Nephrology,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450006,China)

机构地区：[1]郑州市第七人民医院肾移植肾内科,郑州450006

出　　处：《中国实用医刊》2024年第18期44-48,共5页Chinese Journal of Practical Medicine

摘　　要：目的探究尿素、肾损伤分子1(KIM-1)及尿酸水平对肾移植术后发生肾功能延迟恢复(DGF)的预测价值。方法回顾性抽取2021年3月至2023年3月于郑州市第七人民医院进行肾移植手术的122例受者为研究对象,根据是否出现DGF分为DGF组和非DGF组。收集受者的临床数据,比较两组受者尿素、KIM-1及尿酸水平。采用Logistic回归分析肾移植手术后受者出现DGF的危险因素,并采用受试者工作特征曲线分析尿素、KIM-1及尿酸水平对发生DGF的预测价值。结果两组受者性别、年龄、体质指数、高血压、原发病、透析类型、术中输血、人类白细胞抗原错配数比较差异未见统计学意义(P>0.05),两组受者的糖尿病病史比较差异有统计学意义(P<0.05);两组供肾冷缺血时间比较差异有统计学意义(P<0.05)。DGF组的尿素、KIM-1及尿酸水平均高于非DGF组(P均<0.05)。多因素Logistic回归分析结果显示,糖尿病病史、尿素、KIM-1、尿酸水平均是肾移植术后发生DGF的风险因素(P均<0.05),有糖尿病病史、尿素、KIM-1、尿酸水平越高的患者,其发生DGF的风险越大。绘制受试者工作特征曲线结果显示,尿素、KIM-1、尿酸水平预测肾移植术后发生DGF的曲线下面积(AUC)分别为0.620、0.758、0.705,灵敏度分别为48.8%、65.9%、56.1%,特异度分别为80.2%、84.0%、84.0%;三项指标联合预测的AUC为0.863,灵敏度为80.5%,特异度为86.4%。结论肾移植术后发生DGF者的尿素、KIM-1、尿酸水平均高于非DGF者,KIM-1对于肾移植手术后出现DGF的预测价值较好,尿酸水平次之,尿素预测价值最弱,联合预测的效能更高。Objective To evaluate the predictive value of levels of urea,kidney injury molecule-1(KIM-1)and uric acid for occurrence of delayed graft function(DGF)following kidney transplantation.Methods One hundred and twenty-two recipients who underwent kidney transplantation in the Seventh People’s Hospital of Zhengzhou from March 2021 to March 2023 were retrospectively selected,and they were divided into a DGF group and a non-DGF group according to the development of DGF.The clinical data of all recipients were collected,while serum levels of urea,KIM-1 and uric acid were compared between the two groups.Logistic regression analysis was conducted to screen the risk factors for DGF in recipients after kidney transplantation;and the predictive value of urea,KIM-1 and uric acid for DGF was determined using receiver operating characteristic curve.Results No statistical difference was reported between the two groups in gender,age,body mass index,hypertension,primary disease,type of dialysis,intraoperative blood transfusion and human leukocyte antigen mismatch(P>0.05),whereas statistical difference was found in comparison of history of diabetes mellitus between the two groups(P<0.05).There were significant differences in cold ischemia time of the donated kidney between the two groups(P<0.05).The levels of urea,KIM-1,and uric acid in the DGF group were higher than those in the non-DGF group(all P<0.05).Multivariate logistic regression analysis revealed that the history of diabetes mellitus,urea level,KIM-1 level,and uric acid level were all risk factors for DGF in recipients after kidney transplantation(all P<0.05),suggesting that recipients with history of diabetes mellitus,and elevated levels of urea,KIM-1 and uric acid suffered a greater risk of DGF.The results of receiver operating characteristic curve showed that the area under the curve(AUC)of separate test of urea,KIM-1 and uric acid for predicting the occurrence of DGF in recipients after kidney transplantation were 0.620,0.758,and 0.705,respectively,with sensitivities

关 键 词：尿素 肾损伤分子-1 尿酸 肾移植手术 肾功能延迟恢复 

分 类 号：R699.2[医药卫生—泌尿科学]