脓毒症患者急性肾损伤的影响因素及与HBP、Cyr61、CCL3的相关性分析  

Factors influencing acute kidney injury in patients with sepsis and the correlation with HBP,Cyr61 and CCL3

作　　者：赵志杰 吕晓婷 韩婷婷 范斌 ZHAO Zhi-jie;LYU Xiao-ting;HAN Ting-ting(Department of Clinical Laboratory,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院检验科,河北沧州061000

出　　处：《临床和实验医学杂志》2025年第6期576-580,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省卫生健康委科研基金项目(编号:20242155)。

摘　　要：目的分析脓毒症患者发生急性肾损伤(AKI)的影响因素及与肝素结合蛋白(HBP)、富含半胱氨酸蛋白61(Cyr61)、C-C基序趋化因子配体3(CCL3)的相关性。方法回顾性收集2022年7月至2023年12月沧州市人民医院收治的120例脓毒症患者的临床资料。根据患者是否发生AKI分为AKI组(n=44)和非AKI组(n=76)。比较两组患者临床资料,包括性别、年龄、体重指数、既往病史(高血压、冠心病、糖尿病和脑血管病)、是否存在肺部感染、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、序贯器官衰竭量表(SOFA)评分、机械通气和重症监护室(ICU)入住时间、白细胞(WBC)计数、血小板(PLT)计数、基线血肌酐、尿素氮、C-反应蛋白(CRP)、降钙素原、HBP、Cyr61及CCL3水平。使用Logistic逐步回归分析脓毒症患者发生AKI的影响因素,并使用Spearman法分析脓毒症患者发生AKI与PLT计数、HBP、Cyr61、CCL3的相关性。绘制受试者操作特征(ROC)曲线,以曲线下面积(AUC)评价HBP、Cyr61及CCL3对脓毒症患者发生AKI的预测效能。结果两组患者性别、年龄、体重指数、既往病史(高血压、冠心病、糖尿病和脑血管病)、肺部感染、机械通气、ICU入住时间、WBC计数、CRP及降钙素原水平比较,差异均无统计学意义(P>0.05);AKI组患者APACHEⅡ评分、SOFA评分、基线血肌酐、尿素氮、HBP、Cyr61及CCL3水平分别为(22.86±5.49)分、(8.11±2.05)分、(74.13±11.25)μmol/L、(15.26±4.07)mmol/L、(91.35±20.66)ng/mL、(2.24±0.71)μg/L、(18.37±4.16)pg/mL,均高于非AKI组[(19.76±4.83)分、(6.39±1.74)分、(65.38±10.49)μmol/L、(12.19±3.68)mmol/L、(70.94±16.82)ng/mL、(1.68±0.55)μg/L、(14.90±2.87)pg/mL],PLT计数为(176.95±24.83)×10^(9)/L,低于非AKI组[(204.18±31.27)×10^(9)/L],差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,PLT计数下降,HBP、Cyr61及CCL3水平上升为脓毒症患者发生AKI的影响因素(P<0.05)。Spearman法分�Objective To analyze the factors influencing acute kidney injury(AKI)in patients with sepsis,and the correlation with heparin-binding protein(HBP),cysteine-rich angiogenic inducer 61(Cyr61)and C-C motif chemokine ligand 3(CCL3).Methods The clinical data of 120 patients with sepsis admitted to Cangzhou People's Hospital from July 2022 to December 2023 were collected retrospectively.Patients enrolled were divided into the AKI group(n=44)and the non-AKI group(n=76)according to whether AKI occurred.The clinical data of the two groups were compared,including gender,age,body mass index,past medical history(hypertension,coronary heart disease,diabetes and cerebrovascular disease),pulmonary infection,acute physiology and chronic health status evaluationⅡ(APACHEⅡ)score,sequential organ failure scale(SOFA)score,mechanical ventilation and intensive care unit(ICU)stay,white blood cell(WBC)count,platelet(PLT)count,baseline serum creatinine,urea nitrogen,C-reactive protein(CRP),procalcitonin,HBP,Cyr61 and CCL3 levels.And the influencing factors of AKI in patients with sepsis were analyzed by Logistic stepwise regression analysis,and the correlation between AKI and PLT count,HBP,Cyr61 and CCL3 in patients with sepsis was analyzed by Spearman method.The receiver operating characteristic(ROC)curve was drawn,and the predictive efficacy of HBP,Cyr61 and CCL3 for AKI in patients with sepsis was evaluated using the area under the curve(AUC).Results There were no statistically significant differences in gender,age,body mass index,past medical history(hypertension,coronary heart disease,diabetes and cerebrovascular disease),pulmonary infection,mechanical ventilation,ICU stay time,WBC count,CRP and procalcitonin levels between the two groups(P>0.05).The APACHEⅡscore,SOFA score,baseline serum creatinine,urea nitrogen,HBP,Cyr61 and CCL3 levels in the AKI group were(22.86±5.49)points,(8.11±2.05)points,(74.13±11.25)μmol/L,(15.26±4.07)mmol/L,(91.35±20.66)ng/mL,(2.24±0.71)μg/L and(18.37±4.16)pg/mL,respectively,which were higher

关 键 词：脓毒症 急性肾损伤 影响因素 肝素结合蛋白 富含半胱氨酸蛋白61 C-C基序趋化因子配体3 

分 类 号：R459.7[医药卫生—急诊医学]