[1]张志花,崔微艳,赵 平.血清胱抑素C、肝素结合蛋白及SOFA评分对脓毒症患者急性肾损伤的诊断价值[J].医学信息,2024,37(05):116-119.[doi:10.3969/j.issn.1006-1959.2024.05.020]
　ZHANG Zhi-hua,CUI Wei-yan,ZHAO Ping.Diagnostic Value of Serum Cystatin C, Heparin-binding Protein, and SOFA Score for Acute Kidney Injury in Patients With Sepsis[J].Journal of Medical Information,2024,37(05):116-119.[doi:10.3969/j.issn.1006-1959.2024.05.020]
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血清胱抑素C、肝素结合蛋白及SOFA评分对脓毒症患者急性肾损伤的诊断价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年05期
页码:
116-119
栏目:
论著
出版日期:
2024-03-01

文章信息/Info

Title:
Diagnostic Value of Serum Cystatin C, Heparin-binding Protein, and SOFA Score for Acute Kidney Injury in Patients With Sepsis
文章编号:
1006-1959（2024）05-0116-04
作者:
张志花; 崔微艳; 赵 平
（江苏大学附属武进医院/徐州医科大学武进临床学院重症医学科，江苏 常州 213000）
Author(s):
ZHANG Zhi-hua; CUI Wei-yan; ZHAO Ping
(Intensive Care Unit,Wujin Hospital Affiliated with Jiangsu University/The Wujin Clinical college of Xuzhou Medical University,Changzhou 213000,Jiangsu,China)
关键词:
血清胱抑素C; 肝素结合蛋白; 脓毒症; 急性肾损伤
Keywords:
Cystatin C; Heparin-binding protein; Sepsis; Acute kidney injury
分类号:
R631
DOI:
10.3969/j.issn.1006-1959.2024.05.020
文献标志码:
A
摘要:
目的 探讨血清胱抑素C（sCysC）、肝素结合蛋白（HBP）及序贯器官衰竭评分（SOFA评分）在成人脓毒症患者急性肾损伤（SA-AKI）诊断中的应用价值。方法 回顾性分析2020年12月-2022年8月在江苏大学附属武进医院重症医学科收治的76例脓毒症患者，根据患者是否合并急性肾损伤（AKI）分为AKI组（35例）和非AKI组（41例）。比较两组间相关指标，采用Logistic回归分析探讨脓毒症患者急性肾损伤的危险因素，采用受试者工作特征（ROC）曲线分析sCysC、血HBP及SOFA评分对脓毒症患者合并AKI的预测价值。结果 AKI组使用血管活性药物、使用机械通气、sCysC、HBP及SOFA评分均高于非AKI组（P＜0.05）；其中sCysC、HBP及SOFA评分为影响脓毒症患者并发AKI的独立影响因素（P＜0.05）；sCysC、HBP、SOFA评分以及3者联合检测预测脓毒症患者并发AKI的AUC依次为0.671、0.710、0.716、0.815，sCysC、HBP及SOFA评分联合AUC较sCysC及HBP的AUC大（P＜0.05）。结论 sCysC、HBP联合SOFA评分对SA-AKI患者诊断有较高的临床应用价值，可能为临床上SA-AKI患者的治疗提供参考依据，降低患者不良预后的发生率。
Abstract:
Objective To explore the value of serum cystatin C (sCysC), heparin-binding protein (HBP) and sequential organ failure score (SOFA) in the diagnosis of acute kidney injury (SA-AKI) in adult patients with sepsis.Methods A retrospective analysis was performed on 76 patients with sepsis admitted to the Intensive Care Unit, Wujin Hospital Affiliated to Jiangsu University from December 2020 to August 2022. The patients were divided into AKI group (35 patients) and non-AKI group (41 patients) according to whether they had acute kidney injury (AKI). The related indicators between the two groups were compared. Logistic regression analysis was used to explore the risk factors of acute kidney injury in patients with sepsis. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of sCysC, blood HBP and SOFA scores for AKI in patients with sepsis.Results The proportion of vasoactive drugs, the proportion of mechanical ventilation, sCysC, HBP and SOFA scores in the AKI group were higher than those in the non-AKI group (P<0.05). Among them, sCysC, HBP and SOFA scores were independent factors affecting AKI in patients with sepsis (P<0.05); the AUC of sCysC, HBP, SOFA score and their combined detection in predicting AKI in patients with sepsis were 0.671, 0.710, 0.716 and 0.815, respectively. The combined AUC of sCysC, HBP and SOFA score was larger than that of sCysC and HBP (P<0.05).Conclusion sCysC, HBP combined with SOFA score have high clinical application value in the diagnosis of SA-AKI patients, which may provide reference for the treatment of SA-AKI patients and reduce the incidence of poor prognosis.

参考文献/References:

[1]Bellomo R,Kellum JA,Ｒonco C,et al.Acute kidney injury in sepsis[J].Intensive Care Med,2017,43(6):816-828．[2]See EJ,Jayasinghe K,Glassford N,et al.Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure[J].Kidney Int,2019,95(1):160-172.[3]Maiwall R,Kumar A,Bhardwaj A,et al.Cystatin C predicts acute kidney injury and mortality in cirrhotics: A prospective cohort study[J].Liver Int,2018,38(4):654-664.[4]Evans L,Rhodes A,Alhazzani W,et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021[J].Intensive Care Med,2021,47(11):1181-1247.[5]Mizuno T,Sato W,Ishikawa K,et al.KDIGO (Kidney Disease: Improving Global Outcomes) criteria could be a useful outcome predictor of cisplatin-induced acute kidney injury[J].Oncology,2012,82(6):354-359.[6]Jones AE,Trzeciak S,Kline JA.The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation[J].Crit Care Med,2009,37(5):1649-1654.[7]Peerapornratana S,Manrique-Caballero CL,Gómez H,et al.Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment[J].Kidney Int,2019,96(5):1083-1099.[8]Rudd KE,Johnson SC,Agesa KM,et al.Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J].Lancet,2020,395(10219):200-211.[9]Fan C,Ding X,Song Y.A new prediction model for acute kidney injury in patients with sepsis[J].Ann Palliat Med,2021,10(2):1772-1778.[10]冀晓俊,林瑾,王海曼,等.凝血SOFA评分对严重脓毒症相关急性肾损伤患者预后的预测价值[J].中华重症医学电子杂志(网络版),2021,7(2):103-109.[11]Poston JT,Koyner JL.Sepsis associated acute kidney injury[J].BMJ,2019,364:k4891.[12]Costanzo MR,Barasch J.Creatinine and Cystatin C: Not the Troponin of the Kidney[J].Circulation,2018,137(19):2029-2031.[13]Leelahavanichkul A,Souza AC,Street JM,et al.Comparison of serum creatinine and serum cystatin C as biomarkers to detect sepsis-induced acute kidney injury and to predict mortality in CD-1 mice[J].Am J Physiol Renal Physiol,2014,307(8):F939-F948.[14]黄远东,何家富,曾宪升,等.血清肝素结合蛋白和正五聚蛋白-3水平与慢性阻塞性肺疾病合并肺炎的相关性[J].中华实验和临床感染病杂志(电子版),2020,14(3):229-234.[15]Wu YL,Yo CH,Hsu WT,et al.Accuracy of Heparin-Binding Protein in Diagnosing Sepsis: A Systematic Review and Meta-Analysis[J].Crit Care Med,2021,49(1):e80-e90.[16]Bentzer P,Fisher J,Kong HJ,et al.Heparin-binding protein is important for vascular leak in sepsis [J].Intensive Care Med Exp,2016,4(1):33.[17]Chen S,Xie W,Wu K,et al.Suilysin Stimulates the Release of Heparin Binding Protein from Neutrophils and Increases Vascular Permeability in Mice[J].Front Microbiol,2016,7:1338.[18]Fisher J,Linder A.Heparin-binding protein: a key player in the pathophysiology of organ dysfunction in sepsis[J].J Intern Med,2017,281(6):562-574.[19]陈爽,董淮富,陈信,等.肝素结合蛋白在儿童脓毒症早期诊断中的应用价值[J].中华全科医学,2021,19(4):614-616,620.[20]Kahn F,Tverring J,Mellhammar L,et al.Heparin-Binding Protein as a Prognostic Biomarker of Sepsis and Disease Severity at the Emergency Department[J].Shock,2019,52(6):e135-e145.[21]黄亚军,顾玥,张文雯,等.肝素结合蛋白在脓毒症相关急性肾损伤早期诊断中的价值[J].中华实用诊断与治疗杂志,2021,35(5):436-440.

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更新日期/Last Update: 1900-01-01