摘要
目的探讨血心钠肽(ANP)、尿肾损伤分子-1(KIM-1)在脓毒症发生急性肾损伤中的动态变化及意义。方法选取自2012年1月至2012年8月在新疆石河子大学医学院第一附属医院ICU收治的45例脓毒症患者为研究对象,分别在第2 h、6 h、24 h、48 h采集血液及尿液标本用酶联免疫分析法(ELISA)检测ANP和KIM-1。根据脓毒症患者是否在住院期间发生急性肾损伤,分为脓毒症AKI组、脓毒症非AKI组进行对比分析。结果在ICU住院期间17例患者发生AKI,AKI发生率为37.78%。AKI组血ANP在2 h、6 h、24 h、48 h和尿KIM-1在6 h、24 h、48 h明显高于非AKI组(P﹤0.05);2 h血ANP和6 h尿KIM-1与确诊AKI时24 h血清肌酐(Scr)呈正相关(r=0.768,P=0.041;r=0.674,P=0.032)。结论血ANP和尿KIM-1较Scr更早出现升高,其水平变化可以反映肾损害的严重程度,可以预测脓毒症是否发生AKI。
Objective To explore the dynamic changes and clinical significance of atrial natriuretic peptide （ANP） and kidney injury molecule - 1 （ KIM - 1 ） for acute kidney injury （AKI） in patients with sepsis. Methods From Jan. 2012 to Aug. 2012, a total of 45 patients with sepsis were collected at the ICU department of the first affiliated hospital of SHI HE ZI university. Enzyme linked immunosarbent assay （ELISA） was used in the detection of serum ANP and urinary KIM - 1 in 2 h, 6 h, 24 h, 48 h all patients with sepsis. Patients with sepsis were divided into sepsis AKI group and non - AKI group according to whether patients with sepsis occurred with acute kidney injury during hospitaliza- tion. Also the serum ANP and urinary KIM - lof two groups were comparative analysis. Results 17 subjects （37.78%） developed AKI in ICU during the hospitalization. The levels of serum ANP in 2 h, 6 h, 24 h, 48 h and urinary KIM - 1 in 6 h, 24 h, 48 h. The AKI is significantly higher than it in control group （ P 〈 0.05 ）. A significant direct correlation was found between both 2 h serum ANP, 6 h urinary KIM - 1 and 24 h Scrwith the diagnosis ofAKI（ r =0.768,P =0.041;r =0.674,P =0.032）. Conclusion Serum ANP and urinary KIM-1 increases earli- er than Scr, which associates with the severity of acute kidney injury. Both 2 h serum ANP and 6h urinary KIM - 1 can predict the patients with sepsis whether developed to AKI.
出处
《临床和实验医学杂志》
2014年第4期294-297,共4页
Journal of Clinical and Experimental Medicine
关键词
脓毒症
急性肾损伤
心钠肽
肾损伤分子-1
Sepsis
Acute kidney injury
Atrial natriuretic peptide
Kidney injury molecule - 1
