摘要
目的探讨血清可溶性Klotho(sKlotho)、肝细胞生长因子(HGF)水平与体外心肺复苏后发生急性肾损伤(AKI)的关系。方法选取2018年1月—2021年12月江苏大学附属昆山医院急诊医学科收治体外心肺复苏后自主循环恢复患者93例,根据是否发生AKI分为AKI组49例和无AKI组44例,再根据AKI分期将AKI组分为1期亚组13例、2期亚组26例、3期亚组10例。检测患者血清sKlotho、HGF、尿素氮(BUN)、肌酐(SCr)水平,Logistic回归分析心肺复苏后AKI的影响因素,绘制受试者工作特征曲线(ROC)分析血清sKlotho、HGF预测心肺复苏后AKI的价值。结果AKI组血清sKlotho水平低于无AKI组,血清HGF、BUN、SCr水平高于无AKI组(t/P=10.792/<0.001、10.312/<0.001、11.742/<0.001、17.615/<0.001)。血清sKlotho水平3期亚组<2期亚组<1期亚组,血清HGF水平3期亚组>2期亚组>1期亚组(F/P=85.837/<0.001、74.698/<0.001)。AKI患者血清sKlotho水平与BUN、SCr水平呈负相关(r=-0.405、-0.432,P均<0.01),HGF水平与BUN、SCr水平呈正相关(r=0.338、0.398,P均<0.01)。肾上腺素使用剂量高、血清HGF高是心肺复苏后AKI的危险因素,血清sKlotho高是心肺复苏后AKI的保护因素[OR(95%CI)=2.024(1.354~3.025)、1.567(1.255~1.955)、0.535(0.388~0.736)]。血清sKlotho、HGF水平预测心肺复苏后AKI的曲线下面积为0.750、0.736,二者联合预测的曲线下面积为0.896,高于单项预测(Z=4.872、4.474,P均<0.01)。结论心肺复苏后发生AKI患者血清sKlotho水平下降,HGF水平增高,且与AKI发生及肾损伤严重程度有关,是心肺复苏后AKI的潜在预测指标。
Objective To investigate the relationship between serum soluble Klotho(sKlotho)and hepatocyte growth factor(HGF)levels and acute kidney injury(AKI)after in vitro cardiopulmonary resuscitation.Methods A total of 93 patients with recovery of spontaneous circulation after extracorporeal cardiopulmonary resuscitation were selected from January 2018 to December 2021 in the Department of Emergency Medicine of Kunshan Hospital Affiliated to Jiangsu University.They were divided into AKI group(49 cases)and non-AKI group(44 cases)according to whether AKI occurred or not.The AKI group was divided into 13 patients in stage 1 subgroup,26 patients in stage 2 subgroup,and 10 patients in stage 3 subgroup.Serum sKlotho,HGF,blood urea nitrogen(BUN),and creatinine(SCr)levels were detected.Logistic regression analysis of the influencing factors of AKI after cardiopulmonary resuscitation.The receiver operating characteristic curve(ROC)was drawn to analyze the value of serum sKlotho and HGF in predicting AKI after cardiopulmonary resuscitation.Results The serum sKlotho level in the AKI group was lower than that in the non-AKI group,and the serum HGF,BUN,and SCr levels were higher than those in the non-AKI group(t/P=10.792/<0.001,10.312/<0.001,11.742/<0.001,17.615/<0.001).Serum sKlotho level in stage 3 subgroup<stage 2 subgroup<stage 1 subgroup,serum HGF level in stage 3 subgroup>stage 2 subgroup>stage 1 subgroup(F/P=85.837/<0.001,74.698/<0.001).Serum sKlotho levels in AKI patients were negatively correlated with BUN and SCr levels(r=-0.405,-0.432,both P<0.01),and HGF levels were positively correlated with BUN and SCr levels(r=0.338,0.398,Pall<0.01).High dose of epinephrine and high serum HGF are risk factors for AKI after cardiopulmonary resuscitation,and high serum sKlotho is a protective factor for AKI after cardiopulmonary resuscitation[OR(95%CI)=2.024(1.354-3.025),1.567(1.255-1.955),0.535(0.388-0.736)].The areas under the curve of serum sKlotho and HGF levels for predicting AKI after cardiopulmonary resuscitation were 0.750 and 0.
作者
严涛
夏晓华
高勤昌
李文君
汪强
Yan Tao;Xia Xiaohua;Gao Qinchang;Li Wenjun;Wang Qiang(Department of Emergency Medicine, Kunshan Hospital Affiliated to Jiangsu University, Jiangsu Province,Suzhou 215300, China)
出处
《疑难病杂志》
CAS
2022年第7期716-720,共5页
Chinese Journal of Difficult and Complicated Cases
基金
2019年昆山市重点研发计划—社会发展科技专项(KS1964)。
关键词
急性肾损伤
体外心肺复苏
可溶性Klotho
肝细胞生长因子
相关性
Acute kidney injury
Cardiopulmonary resuscitation in vitro
Soluble Klotho
Hepatocyte growth factor
Relationship
