赵春艳.联合检测血清高迁移率族蛋白B1、可溶性髓系细胞触发受体-1对脓毒症并发急性肾损伤有预测价值[J].内科急危重症杂志,2024,30(4):317-321
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| DOI：10.11768/nkjwzzzz20240407 |
| 中文关键词: 血清高迁移率族蛋白B1 可溶性髓系细胞触发受体 1 脓毒症 急性肾损伤 |
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| 中文摘要: |
| 摘要 目的：探究联合检测血清高迁移率族蛋白B1（HMGB1）、可溶性髓系细胞触发受体-1（sTREM-1）对脓毒症并发急性肾损伤（AKI）的诊断价值。方法：选取120例脓毒症患者，分为AKI组47例与非AKI组73例。采用酶联免疫吸附法（ELISA）检测2组血清肌酐、C反应蛋白、胱抑素C、HMGB1、sTREM-1水平；检测2组血清白细胞计数、血红蛋白水平；采用分光光度法检测2组乳酸水平；使用免疫比浊法检测2组白蛋白水平。2组均进行序贯器官衰竭评分（SOFA）、急性生理与慢性健康状况评估（APACHE Ⅱ）评分。比较2组以上指标，采用单因素分析和多因素Logistic回归分析脓毒症患者并发AKI的独立影响因素。绘制受试者工作特征（ROC）曲线，评估各指标对预后的预测价值。结果：血肌酐、胱抑素C、乳酸、HMGB1、sTREM-1水平、SOFA评分、APACHE Ⅱ评分为脓毒症患者并发AKI的独立危险因素（P均<0.05）。HMGB1联合sTREM-1诊断脓毒症AKI的ROC曲线下面积（AUC）为0.879，优于HMGB1、sTREM-1单独诊断（AUC分别为0.778、0.823）。结论：血清HMGB1、sTREM-1是脓毒症患者并发AKI的独立危险因素，联合检测HMGB1、sTREM-1对于诊断脓毒症并发AKI的价值优于单独检测，可作为评估该类患者病情的敏感指标。 |
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| Abstract Objective: To explore the diagnostic value of serum high mobility group box 1(HMGB1) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in sepsis complicated with acute kidney injury (AKI). Method: A total of 120 patients with sepsis were divided into AKI group (47 cases) and non-AKI group (73 cases). Serum creatinine, C-reactive protein, cystatin C, HMGB1 and sTREM-1 levels in 2 groups were detected by enzyme-linked immunosorbent assay (ELISA). Serum white blood cell count and hemoglobin level were detected in 2 groups. The lactic acid level of the two groups was detected by spectrophotometry. The levels of albumin in 2 groups were detected by immunoturbidimetry. Sequential organ failure score (SOFA) and Acute Physiological and Chronic Health status Assessment (APACHEII) scores were performed in both groups. The two groups of indicators were compared, and univariate analysis and multivariate Logistic regression were used to analyze the independent influencing factors of patients with sepsis complicated with AKI. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of each indicator. Results: Serum creatinine, cystatin C, lactic acid, HMGB1, sTREM-1, SOFA score and APACHE Ⅱ score were independent risk factors for AKI in sepsis patients (all P<0.05). The area under ROC curve (AUC) of HMGB1 combined with sTREM-1 in diagnosing septic AKI was 0.879, which was better than that of HMGB1 and sTREM-1 alone (AUC was 0.778 and 0.823, respectively). Conclusions: Serum HMGB1 and sTREM-1 are independent risk factors for AKI in patients with sepsis. Combined detection of HMGB1 and sTREM-1 is superior to single detection in the diagnosis of AKI in patients with sepsis, and can be used as sensitive indicators to evaluate the condition of these patients. |
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