| 杨云飞,王爱田,赵华灵,等.多项生物学标志物联合检测对老年重症病人合并急性肾损伤早期的诊断价值[J].安徽医药,2023,27(7):1408-1412. |
| 多项生物学标志物联合检测对老年重症病人合并急性肾损伤早期的诊断价值 |
| Value of combined detection of multiple biomarkers in the early diagnosis of acute kidney injury in elderly critically ill patients |
| |
| DOI：10.3969/j.issn.1009-6469.2023.07.030 |
| 中文关键词: 危重病 急性肾损伤 金属蛋白酶阻滞抑制剂 -2 胰岛素样生长因子结合蛋白 -7 重症监护病房 |
| 英文关键词: Critical illness Acute kidney injury Metalloproteinase block inhibitor-2 Insulin-like growth factor binding protein-7 Intensive care units |
| 基金项目:2022年度河北省医学科研课题计划( 20221584) |
|
| 摘要点击次数: 732 |
| 全文下载次数: 335 |
| 中文摘要: |
| 目的探究多项生物学标志物联合检测在老年重症病人合并急性肾损伤( AKI)早期诊断中的价值。方法选取 2020年 5月至 2021年 6月开滦总医院收治的 150例老年重症病人作为研究对象，根据 AKI发生与否分为 AKI组( n=56)与非 AKI组(n=94)。比较两组临床资料、入住 ICU即刻、 4h、12 h、24 h尿［金属蛋白酶阻滞抑制剂 -2(TIMP-2)］×［胰岛素样生长因子结合蛋白 -7(IGFBP7)］分析不同时间点［ TIMP-2］×［IGFBP-7］与重症病人 AKI及预后不良的关系，绘制受试者操作特征曲线( ROC曲线)，评价不同时间，点［ TIMP-2］×［IGFBP-7］对重症病人 AKI的诊断价值。结果 AKI组年龄、高血压、 APACHEⅡ评分、血乳酸、肌酐、降钙素原、谷丙转氨酶、动脉血氧分压、动脉血二氧化碳分压与非 AKI组比较，差异有统计学意义( P<0.05)； AKI组 ICU 4 h、12 h、24 h尿［ TIMP-2］×［IGFBP-7］分别为( 0.45±0.08)、(0.68±0.17)、(0.89±0.27)、(1.13±0.32)(μg/L)2 均高于非 AKI组2(0.43±0.07)、(0.50±0.14)、(0.54±0.18)、(0.75±0.21)(μg/L)(P<0.05)； logistic回归方程调整年龄、高血压、 APACHEⅡ评分、血乳酸、肌酐、降钙素原、谷丙转氨酶、动脉血氧分压、动脉血二氧化碳分压等其他混杂因素后，结果显示， ICU4 h、12 h、24 h尿［TIMP-2］×［IGFBP-7］均为重症病人 AKI发生独立危险因素( P<0.05)；绘制不同时间点［ TIMP-2］×［IGFBP-7］对重症病人 AKI诊断价值的 ROC曲线，结果显示 ICU 4 h、12 h、24 h尿［ TIMP-2］×［IGFBP-7］对重症病人 AKI诊断价值的曲线下面积( AUC)分别为 0.778、0.830、0.875；Cox单因素、多因素分析均显示 ICU 4 h、12 h、24 h尿［ TIMP-2］×［IGFBP-7］与重症病人预后不良有关(P<0.05)。结论老年重症病人入住 ICU后 4h、12 h、24 h尿［ TIMP-2］×［IGFBP-7］水平对 AKI具有早期评估价值，可作为 AKI早期预警、诊断指标，值得临床推广与应用。 |
| 英文摘要: |
| Objective To explore the value of combined detection of multiple biomarkers in the early diagnosis of acute kidney injury (AKI) in elderly critically ill patients. Methods One hundred and fifty elderly critically ill patients admitted to Kailuan General Hospital from May 2020 to June 2021 were selected as the research subjects. According to the occurrence of AKI, they were divided into AKI group (n=56) and non-AKI group (n=94). The clinical data and immediately after admission to ICU, 4 h, 12 h, 24 h urine [metalloproteinase blocker-2 (TIMP-2)] × [insulin-like growth factor binding protein-7 (IGFBP7)] value of the two groups were compared. The relationship between [TIMP-2]×[IGFBP-7] value at different time points and AKI and poor prognosis in severe patients was analyzed,receiver operating characteristic (ROC) curve was drawn, and the diagnostic value of different time points [TIMP-2]×[IGFBP-7] in severe patients with AKI was evaluated.Results The differences in age, hypertension, APACHE Ⅱscore, blood lactic acid, creatinine,procalcitonin, alanine aminotransferase, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide between the AKIgroup and the non-AKI group were statistically significant (P<0.05). The urine [TIMP-2]×[IGFBP-7] values at 4 h, 12 h, 24 h in ICU of AKI group were (0.45±0.08)(μg/L)2, (0.68±0.17)(μg/L)2, (0.89±0.27)(μg/L)2, and (1.13±0.32)(μg/L)2, respectively, which were higher than those of the non AKI group (0.43±0.07)(μg/L)2, (0.50±0.14)(μg/L)2, (0.54±0.18)(μg/L)2, and (0.75±0.21)(μg/L)2 (P<0.05). Logisticregression equation showed that after adjusting other confounding factors such as age, hypertension, APACHE Ⅱ score, blood lactate,creatinine, procalcitonin, alanine transaminase, arterial oxygen partial pressure and arterial blood carbon dioxide partial pressure, theurine [TIMP-2]×[IGFBP-7] value at 4 h, 12 h, 24 h in ICU were independent risk factors for AKI in critically ill patients (P<0.05); ROC curves of the diagnostic value of urine [TIMP-2]×[IGFBP-7] value at different time points for AKI in critically ill patients were drawn.The results showed that the area under the curve (AUC) of urine [TIMP-2]×[IGFBP-7] values at 4 h, 12 h, 24 h in ICU for AKI diagnostic value in critically ill patients were 0.778, 0.830, and 0.875, respectively. Cox univariate and multivariate analysis showed that urine[TIMP-2]×[IGFBP-7] value at 4 h, 12 h and 24 h in ICU was related to poor prognosis of severe patients (P<0.05).Conclusion The level of urine [TIMP-2]×[IGFBP-7] exceeding the diagnostic value at 4 h, 12 h, and 24 h after admission to ICU in elderly patients withcritical illness has an early assessment value for AKI, which can be used as an early warning and diagnostic indicator of AKI, and it isworthy of clinical promotion and application. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
