摘要
目的 探讨血清上游刺激因子2(upstream stimulatory factor 2,USF2)和血小板反应蛋白-1(thrombospondin-1,THBS1)对脓毒症急性肾损伤(acute kidney injury,AKI)的诊断价值。方法 选取2020年10月~2022年10月中国人民解放军西藏军区总医院收治的109例脓毒症患者,分为AKI组(n=45)和非AKI组(n=64)。收集患者临床资料,检测两组血清USF2和THBS1水平,Pearson分析血清USF2和THBS1与脓毒症患者肾功能指标的相关性。多因素Logistic回归分析脓毒症AKI的危险因素,受试者工作特征(ROC)曲线分析血清USF2和THBS1对脓毒症AKI的诊断效能。结果 AKI组血清尿素氮(blood urea nitrogen,BUN)、肌酐(serum creatinine,s Cr)、胱抑素C(cystatin C,Cys C)、C反应蛋白、降钙素原水平、急性生理与慢性健康状况评分Ⅱ评分、序贯器官衰竭评分(sequential organ failure assessment,SOFA)高于非AKI组,差异均有统计学意义(t=20.983,33.063,10.641,6.735,7.472,8.487,10.578,均P <0.05)。AKI组血清USF2(3.26±1.04 vs 1.27±0.36)和THBS1水平(172.35±53.19 ng/ml vs 103.64±32.56 ng/ml)高于非AKI组,差异有统计学意义(t=14.171,8.353,均P <0.05)。AKI患者血清USF2,THBS1与BUN,s Cr,Cys C呈正相关(r=0.619,0.507,0.432;0.596,0.607,0.547,均P <0.05)。高SOFA评分[OR(95%CI)=3.170(1.754~5.731)]、高USF2[OR(95%CI)=1.680(1.116~2.531)]、高THBS1[OR(95%CI)=1.603(1.113~2.308)]是发生脓毒症AKI的危险因素(均P <0.05)。血清USF2,THBS1及二者联合诊断脓毒症AKI的曲线下面积分别为0.778(95%CI:0.689~0.852),0.755(95%CI:0.663~0.832)和0.947(95%CI:0.887~0.981)。结论 脓毒症AKI患者血清USF2和THBS1水平均显著增高,且与肾功能下降以及AKI的发生有关,可用于辅助诊断脓毒症AKI。
Objective To investigate the diagnostic value of serum upstream stimulatory factor-2(USF2)and thrombospondin-1(THBS1)in acute kidney injury(AKI)in sepsis.Methods 109 sepsis patients admitted to the General Hospital of Tibet Military Region of the Chinese People’s Liberation Army from October 2020 to October 2022 were selected and divided into AKI group(n=45)and non AKI group(n=64).Clinical data of patients were collected and serum levels of USF2 and THBS1 were measured in two groups,pearson analysis was conducted to investigate the correlation between serum USF2 and THBS1 and renal function indicators in sepsis patients.Multivariate logistic regression analysis was used to identify the risk factors for sepsis associated AKI,and the diagnostic efficacy of serum USF2 and THBS1 in sepsis associated AKI was analyzed using the subject's working characteristic curve.Results The levels of serum urea nitrogen(BUN),serum creatinine(sCr),cystatin C(Cys C),C-reactive protein,procalcitonin,acute physiological and chronic health status score II,and sequential organ failure assessment(SOFA)in AKI group were higher than those in non AKI group,and the difference was statistically significant(t=20.983,33.063,10.641,6.735,7.472,8.487,10.578,all P<0.05).The serum levels of USF2(3.26±1.04 vs 1.27±0.36)and THBS1(172.35±53.19 ng/ml vs 103.64±32.56 ng/ml)in the AKI group were higher than those in the non AKI group,and the difference was statistically significant(t=14.171,8.353,all P<0.05).The serum levels of USF2 and THBS1 in AKI patients were positively correlated with BUN,sCr and CysC(r=0.619,0.507,0.432;0.596,0.607,0.547,all P<0.05).High SOFA score[OR(95%CI)=3.170(1.754~5.731)],high USF2[OR(95%CI)=1.680(1.116~2.531)],and high THBS1[OR(95%CI)=1.603(1.113~2.308)]were risk factors for sepsis AKI(all P<0.05).The area under the curve of serum USF2,THBS1 and their combination in diagnosing sepsis AKI were 0.778(95%CI:0.689~0.852),0.755(95%CI:0.663~0.832)and 0.947(95%CI:0.887~0.981),respectively.Conclusion The serum levels of USF2 a
作者
赵瑞臣
陈春燕
何琴
ZHAO Ruichen;CHEN Chunyan;HE Qin(Department of Emergency,the General Hospital of Tibet Military Region of the Chinese People’s Liberation Army,Lhasa 850007,China;Department of Clinical Laboratory,the General Hospital of Tibet Military Region of the Chinese People’s Liberation Army,Lhasa 850007,China)
出处
《现代检验医学杂志》
CAS
2023年第6期98-102,184,共6页
Journal of Modern Laboratory Medicine
基金
西藏自治区科技计划项目(XZ2019ZRG-122):TGF-B/SMAD信号通路参与脓毒症急性肾损伤的机制。
