摘要
目的探究脓毒症并发急性肾损伤(AKI)患者血清组蛋白去乙酰基转移酶4(HDAC4)和锌指蛋白转录因子5(KLF5)表达及临床价值。方法选取2020年9月—2022年9月本院收治的60例脓毒症并发AKI患者作为AKI组,选取同期北京市大兴区人民医院收治的75例脓毒症未发生AKI患者作为非AKI组。比较两组的临床资料、血清HDAC4和KLF5水平。ROC分析血清HDAC4和KLF5对脓毒症患者并发AKI的诊断价值。Logistic回归分析影响脓毒症患者并发AKI的因素。结果与非AKI组相比,AKI组患者血清HDAC4、KLF5、降钙素原(PCT)、肌酐(Cr)、序贯性器官衰竭(SOFA)、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分较高,AKI组血小板计数(PLT)较低,差异有统计学意义(P<0.05)。随着AKI组患者分期升高,血清HDAC4和KLF5水平依次升高,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清HDAC4、KLF5可辅助诊断脓毒症患者是否并发AKI的曲线下面积(AUC)是0.800(95%CI:0.723~0.876)、0.810(95%CI:0.735~0.886);二者联合诊断的AUC为0.908(95%CI:0.856~0.961),均优于各自单独检测(Z=2.277、2.102,P<0.05)。Logistic回归分析显示,APACHEⅡ评分、SOFA评分、HDAC4、KLF5是影响脓毒症患者是否并发AKI的危险因素(P<0.05)。结论脓毒症并发AKI患者血清HDAC4、KLF5水平升高,且二者联合检测对脓毒症并发AKI的诊断效能较高,对评估脓毒症并发AKI有较好的临床诊断价值。
Objective To investigate the expression and clinical value of serum histone deacetyltransferase 4(HDAC4)and Krüpper like factor 5(KLF5)in patients with sepsis complicated by acute kidney injury(AKI).Methods Sixty patients with sepsis complicated with AKI admitted to our hospital from September 2020 to September 2022 were collected as the AKI group,and 75 sepsis patients who did not experience AKI admitted to our hospital during the same period as the non AKI group.The clinical data and serum levels of HDAC4 and KLF5 were compared between the two groups.ROC was applied to analyze the diagnostic value of serum HDAC4 and KLF5 in sepsis patients with AKI.Logistic regression was applied to analyze the factors affecting sepsis patients with AKI.Results Compared with the non AKI group,the serum HDAC4,KLF5,PCT,Cr,SOFA score,and APACHE II score in the AKI group were higher,while the PLT was lower(P<0.05).As the stage of patients in AKI group increased,the serum levels of HDAC4 and KLF5 increased sequentially(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum HDAC4 and KLF5 for assisting in the diagnosis of sepsis patients with AKI was 0.800(95%CI:0.723-0.876),0.810(95%CI:0.735-0.886)respectively;the AUC of the combined diagnosis of the two was 0.908(95%CI:0.856-0.961),which was better than the individual detection(Z=2.277,2.102,P<0.05).Logistic regression analysis showed that APACHE II score,SOFA score,HDAC4,and KLF5 were risk factors for sepsis patients with AKI(P<0.05).Conclusion The serum levels of HDAC4 and KLF5 in patients with sepsis complicated by AKI increase,and the combined detection of the two has a high diagnostic efficacy for sepsis complicated by AKI,which has good clinical diagnostic value for evaluating sepsis complicated by AKI.
作者
李玉伟
王瑾
乔薇
王助衡
LI Yuwei;WANG Jin;QIAO Wei;WANG Zhuheng(Department of Critical Care Medicine,Beijing Daxing District People's Hospital,Beijing 102600,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第3期359-363,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
北京市大兴区人民医院科研课题(编号:4202201414)。
关键词
脓毒症并发肾损伤
组蛋白去乙酰基转移酶4
锌指蛋白转录因子5
临床价值
Sepsis complicated with renal injury
Histone deacetyltransferase 4
Zinc finger protein transcription factor 5
Clinical value
