摘要
目的:研究尿肾损伤分子-1(u KIM-1)、血清肌酐(s Cr)、白介素-6(IL-6)及T细胞亚群在脓毒症致急性肾损伤(AKI)中的临床应用价值。方法:选择ICU脓毒症患者69例,根据有无肾功能损害分为脓毒症急性肾损伤组(AKI组)、非肾损伤组(非AKI组),其中AKI组患者39例,非AKI组患者30例。选择同期门诊健康体检者30例作为对照组。测定研究对象入科0、6、24、48 h血清肌酐与u KIM浓度以及入科24 h血清IL-6、T细胞亚群浓度,根据24 h内最差临床指标计算急性生理和慢性健康计算(APACHEⅡ)评分;采用统计软件SPSS13.0进行统计学分析。结果:脓毒症AKI组患者s Cr、u KIM-1和血清IL-6检测结果均明显高于脓毒症非AKI组(P均<0.05),与s Cr诊断AKI时间相比,u KIM-1能更早地诊断脓毒症急性肾损伤,且IL-6、u KIM-1与APACHEⅡ评分呈正相关。AKI组与非AKI组患者,外周血CD_3^+T、CD_4^+T和CD_8^+T细胞及CD_4^+T/CD_8^+T均明显低于对照组,AKI组低于非AKI组,差异均有统计学意义(P均<0.05)。结论:u KIM-1、血清IL-6及T细胞亚群监测可用于评估脓毒症致急性肾损伤病情及预后,u KIM-1比s Cr对脓毒症急性肾损伤有更好的诊断效能。
Objective:To analyze the relationship among the expression levels of kidney injury molecule-1(KIM-1),creatinine,interleukin-6,and T-cell subsets in patients with acute kidney injury(AKI)induced by sepsis.Methods:Sixty-nine patients with sepsis admitted to ICU were divided into non-AKI group(n=30)and AKI group(n=39).Thirsty healthy people were also enrolled as healthy control group.The serum creatinine,uKIM,IL-6,T-cell subsets and acute physiology and chronic health evaluation(APACHE II)score were compared between2group,and the correlations among them were analyzed.Results:The blood level of creatinine,KIM and IL-6were significantly higher in AKI group than those in non-AKI group.In AKI group,the CD3+T,CD4+T,CD8+T and CD4+T/CD8+T were significantly lower than those in non-AKI group.The differences were significantly different between the patients in the two groups.Conclusion:The blood level of KIM and IL-6and the changes of T-cell subsets could be used to evaluate the degree of the disease and its prognosis.uKIM is more affected than creatinine.
作者
杨宏伟
牛文彦
YANG Hong-wei;NIU Wen-yan(Department of Immunology,Tianjin Medical University, Tianjin 300070, China)
出处
《天津医科大学学报》
2018年第2期145-147,155,共4页
Journal of Tianjin Medical University
