摘要
目的探究脓毒症患者血清人类软骨糖蛋白-39(YKL-40)水平检测与急性肾损伤(acute kidney injury,AKI)早期诊断的相关性研究。方法选择2018年7月~2020年2月西安高新医院急诊科收治的170例脓毒症患者为研究对象,根据患者入住ICU后24 h内是否发生AKI分为AKI组和非AKI组。采用酶联免疫吸附法(ELISA)检测血清YKL-40的水平。结果AKI组和非AKI组的平均年龄、吸烟史、饮酒史、白细胞计数(white blood cell count,WBC)比较差异均无统计学意义(t=0.37,χ^(2)=1.71,χ^(2)=0.90,t=0.67,均P>0.05),AKI组的血肌酐(serum creatinine,SCr)和YKL-40水平均高于非AKI组,其差异均有统计学意义(χ^(2)=5.97,10.11,均P<0.05)。脓毒症伴AKI-Ⅲ期患者血清YKL-40水平高于脓毒症伴AKI-Ⅱ期和AKI-Ⅰ期,脓毒症伴AKI-Ⅱ期显著高于AKI-Ⅰ期,其组间差异具有统计学意义(F=1.37,P=0.00)。Pearson相关法分析结果显示,血清YKL-40水平与SCr和AKI分期呈正相关关系(r=0.19,0.25,P=0.00)。ROC曲线分析结果显示,区别诊断AKI及非AKI患者时,血清YKL-40的AUC为0.88(95%CI 0.81~0.94),当cut-off值为4.20 ng/mg时,特异度和灵敏度分别为0.75和0.78。区别诊断脓毒症伴AKI-Ⅲ期与AKI-Ⅰ/Ⅱ期患者时,血清YKL-40的AUC为0.82(95%CI 0.71~0.94),当cut-off值为6.79 ng/mg时,特异度和灵敏度分别为0.83和0.72。结论血清YKL-40在脓毒症伴AKI患者中高表达,可用于诊断AKI和判断AKI的严重程度。
Objective To investigate the correlation between serum YKL-40 level and early diagnosis of acute kidney injury(AKI)in patients with sepsis.Methods A total of 170 sepsis patients admitted to the emergency department of Xi’an Gaoxin Hospital from July 2018 to February 2020 were selected as the study subjects,and the patients were divided into AKI group and non-AKI group according to whether AKI occurred within 24 hours after admission to ICU.Serum YKL-40 levels were detected by enzyme-linked immunosorbent assay(ELISA).Results There were no statistically significant differences in average age,smoking history,drinking history and white blood cell count(WBC)between AKI group and non-AKI group the difference were statistically(t=0.37,χ^(2)=1.71,χ^(2)=0.90,t=0.67,all P>0.05),but serum creatinine(SCr)and YKL-40 levels in AKI group were higher than those in non-AKI group,the difference between the two group was statistically significant(χ^(2)=5.97,10.11,all P<0.05).The level of serum YKL-40 in patients with sepsis and AKI-Ⅲ was higher than that in patients with sepsis and AKI-Ⅱ and AKI-Ⅰ,and the level of serum YKL-40 in patients with sepsis and AKI-Ⅱ was significantly higher than that in patients with AKI-Ⅰ,and the difference between groups was statistically significant(F=1.37,P=0.00).The results of Pearson correlation analysis showed that serum YKL-40 level was positively correlated with SCr and AKI staging(r=0.19,0.25,P=0.00).ROC curve analysis results showed that the AUC of serum YKL-40 was 0.88(95%CI 0.81~0.94)when discriminating between AKI and non-AKI patients.The specificity and sensitivity were 0.75 and 0.78 respectively when the Cut-off value was 4.20 ng/mg.The AUC of serum YKL-40 was 0.82(95%CI 0.71~0.94)in sepsis patients with stage Ⅲ AKI-Ⅰ/Ⅱ,and the specificity and sensitivity were 0.83 and 0.72 respectively when the cut-off value was 6.79 ng/mg.Conclusion Serum YKL-40 is highly expressed in sepsis patients with AKI,and can be used to diagnose and judge the severity of AKI.
作者
张珍
王新庄
ZHANG Zhen;WANG Xin-zhuang(Department of Emergency,Xi’an Gaoxin Hospital,Xi’an 710075,China)
出处
《现代检验医学杂志》
CAS
2021年第3期148-150,共3页
Journal of Modern Laboratory Medicine
