• 联合检测血清正五聚蛋白、高迁移率族蛋白1及微小RNA-21对急性肾损伤有预测价值
  • 史添立.联合检测血清正五聚蛋白、高迁移率族蛋白1及微小RNA-21对急性肾损伤有预测价值[J].内科急危重症杂志,2023,29(4):277-279
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    DOI:10.11768/nkjwzzzz20230404
    中文关键词:  正五聚蛋白  高迁移率族蛋白1  微小RNA-21  急性肾损伤  预测价值
    英文关键词:
    基金项目:海南省卫生计生行业科研项目(No:19A200052)
    作者单位E-mail
    史添立 海口市人民医院 babifly@163.com 
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    中文摘要:
          摘要 目的:探讨血清正五聚蛋白(PTX3)、高迁移率族蛋白1(HMGB-1)及微小RNA(miR)-21在急性肾损伤(AKI)中的表达及意义。方法:随机选取87例AKI患者为研究组,并选择同期体检的健康人50例为对照组,参照改善全球肾脏病预后组织分期标准,其中Ⅰ期23例,Ⅱ期33例,Ⅲ期31例,根据预后(住院后28d内)情况分为死亡组19例和存活组68例。监测患者血清PTX3、HMGB-1及miR-21水平并绘制受试者工作特征(ROC)曲线,计算最佳诊断截断值和曲线下面积(AUC),分析其对AKI的预测价值。结果:研究组患者血清PTX3、HMGB-1水平高于对照组,miR-21水平低于对照组(P均<0.05);Ⅰ期患者血清PTX3、HMGB-1水平低于Ⅱ期、Ⅲ期患者,且Ⅱ期低于Ⅲ期;Ⅰ期患者miR-21水平高于Ⅱ期、Ⅲ期患者,且Ⅱ期高于Ⅲ期(P均<0.05);死亡组患者血清PTX3、HMGB-1水平高于存活组,miR-21水平低于存活组(P均<0.05);PTX3诊断AKI的截断值为13.28ng/L,AUC为0.833(95%CI:0.771~0.895);HMGB-1诊断AKI的的截断值为11.40pg/mL,AUC为0.916(95%CI:0.901~0.935);miR-21诊断AKI的的截断值为0.89,AUC为0.895(95%CI:0.842~0.947);3项联合检测诊断AKI的AUC为0.989(95%CI:0.981~0.999),优于各指标单独预测(Z=4.873、8.062、3.479,P均<0.05)。结论:AKI患者血清PTX3、HMGB-1及miR-21水平表达明显异常,联合检测有预测价值。
    英文摘要:
          Abstract Objective: To study the predictive value of serum pentameric protein (PTX3), high mobility group protein 1 (HMGB-1) and miR-21 in acute kidney injury. Methods: Totally, 87 patients with acute kidney injury were selected as the study group, and 50 healthy patients who received physical examination in our hospital during the same period were selected as the control group. The changes of serum PTX3, HMGB-1 and miR-21 levels and their predictive value were analyzed. Results: The serum levels of PTX3 and HMGB-1 in the study group were significantly higher than those in the control group, and the levels of Mir-21 were significantly lower than those in the control group (P< 0.05). The serum levels of PTX3 and HMGB-1 in stage I acute kidney injury patients were significantly lower than those in acute kidney injury stage Ⅱ and Ⅲ patients, and the level of Mir-21 was significantly higher in stage I acute kidney injury patients than that in stage Ⅱ and Ⅲ patients. The serum levels of PTX3 and HMGB-1 in acute kidney injury stage Ⅱ patients were significantly lower than those in stage Ⅲ patients, and the level of Mir-21 was significantly higher in stage Ⅱ acute kidney injury patients than that in stage Ⅲ patients. The difference was significant (P< 0.05). The levels of serum PTX3 and HMGB-1 in death group were significantly higher than those in survival group, and the levels of Mir-21 in death group were significantly lower than those in survival group with the differences being significant (P< 0.05). The AUC of PTX3 in the diagnosis of acute kidney injury was 0.833 and 95%CI was 0.771-0.895. The AUC of HMGB-1 in the diagnosis of acute kidney injury was 0.916 and 95%CI was 0.901-0.935. The AUC of Mir-21 in the diagnosis of acute kidney injury was 0.895 and 95%CI was 0.842-0.947. The AUC of combined detection for acute kidney injury was 0.989, 95%CI was 0.981-0.999, and there was significant difference in AUC area (Z=4.873, 8.062, 3.479, P< 0.05). Conclusion: Serum PTX3, HMGB-1 and miR-21 were significantly abnormal in patients with acute kidney injury, which could be used as an important indicator for the diagnosis of acute kidney injury.