老年慢性肾脏病患者外周血受体相互作用蛋白3中性粒细胞凝胶酶相关脂蛋白和β2微球蛋白水平变化及对急性肾损伤发生的预测效能  

Peripheral blood levels of receptor-interacting protein kinase 3,neutrophil gelatinase-associated lipocalin,andβ2-microglobulin in elderly patients with chronic kidney disease and their predictive efficacy for acute kidneyinjury

作　　者：郭利芹 布海霞[1] 王焕[1] Guo Liqin;Bu Hairia;Wang Huan(Nephrology Department,Xinriang Central Hospital,Xinriang 453000,China)

机构地区：[1]新乡市中心医院肾内科,新乡453000

出　　处：《中华老年医学杂志》2024年第11期1463-1467,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨老年慢性肾脏病患者外周血受体相互作用蛋白3(RIP3)、中性粒细胞凝胶酶相关脂蛋白(NGAL)和β2微球蛋白(β2M)水平变化及对急性肾损伤发生的预测效能。方法回顾性分析2022年6月至2024年6月在新乡市中心医院诊断为慢性肾脏病的老年患者119例,依据患者是否发生急性肾损伤分为发生组(58例)和未发生组(61例),比较两组患者的一般临床资料,采用酶联免疫吸附试验(ELISA)方法测定RIP3、NGAL及β2M的水平,采用Logistic回归分析老年慢性肾脏病患者发生急性肾损伤的影响因素,受试者工作特征曲线(ROC曲线)和曲线下面积(AUC)用于评估RIP3、NGAL及β2M对老年慢性肾脏病患者发生急性肾损伤的评估价值。结果与未发生组患者比较,发生组患者的血清肌酐、RIP3、NGAL及β2M水平升高(t=2.008、7.729、7.680、7.447,均P<0.05);Logistic回归分析结果显示,RIP3(OR=1.760,95%CI:1.164~2.664)、NGAL(OR=1.856,95%CI:1.215~2.834)、β2M(OR=1.454,95%CI:1.118~1.891)均为老年慢性肾脏病患者发生急性肾损伤的危险因素(均P<0.05);ROC分析结果显示,RIP3、NGAL、β2M及三者联合对老年慢性肾脏病患者发生急性肾损伤进行预测的灵敏度分别为65.52%、94.83%、65.52%、87.93%,特异度分别为91.80%、70.49%、93.44%、95.08%,AUC分别为0.833(0.754~0.895)、0.901(0.832~0.948)、0.806(0.7230.872)、0.975(0.928~0.995);对各指标及三者联合的预测价值进行比较结果显示,三者联合的预测价值高于RIP3、NGAL、β2M单独预测(Z=4.131、3.305、4.218,均P<0.001)。结论外周血RIP3、NGAL、β2M三者联合对老年慢性肾脏病患者急性肾损伤发生的预测效能较高。Objective To investigate the changes in peripheral blood levels of receptor interacting protein kinase 3(RIP3),neutrophil gelatinase-associated lipocalin(NGAL),andβ2-microglobulin(β2M)in older patients with chronic kidney disease,as well as their predictive efficacy for acute kidney injury.Methods A retrospective analysis was conducted involving 119 older patients diagnosed with chronic kidney disease at Xinxiang Central Hospital from June 2022 to June 2024.The patients were categorized into an acute kidney injury(AKI)group(n=58)and a non-AKI group(n=61)based on the presence of acute kidney injury.General clinical data were compared between the two groups;levels of RIP3,NGAL,and p2M were quantified using enzyme-linked immunosorbent assay(ELISA).Logistic regression analysis was performed to identify multifactorial factors influencing the occurrence of acute kidney injury in older patients with chronic kidney disease.Furthermore,receiver operating characteristic(ROC)curve analysis and the area under the curve(AUC)were utilized to assess the predictive value of RIP3,NGAL,andβ2M for acute kidney injury in this patient population.Results In comparison to the non-AKI group,patients in the AKI group exhibited significantly elevated levels of serum creatinine(Scr),RIP3,NGAL,andβ2M(t=2.008,7.729,7.680,7.447,all P<0.05).Logistic regression analysis identified RIP3(OR=1.760,95%CI:1.164-2.664),NGAL(OR=1.856,95%CI:1.215-2.834),andβ2M(OR=1.454,95%CI:1.118-1.891)as risk factors for acute kidney injury in older patients with chronic kidney disease(all P<0.05).Furthermore,ROC curve analysis demonstrated that RIP3,NGAL,β2M,and their combination had sensitivities of 65.52%,94.83%,65.52%,and 87.93%,specificities of 91.80%,70.49%,93.44%,and 95.08%,and AUCs of 0.833,0.901,0.806,and 0.975,respectively.The predictive value of RIP3,NGAL,β2M,and their combination surpassed that of individual predictors(Z=4.143,3.305,4.218,all P<0.001).Conclusions The combined assessment of peripheral blood RIP3,NGAL,andβ2M demonstrates superior pr

关 键 词：肾病 Β2微球蛋白 肾损伤 受体相互作用蛋白3 中性粒细胞凝胶酶相关脂蛋白 

分 类 号：R692[医药卫生—泌尿科学]