[1]赵瑞臣a,陈春燕b,何 琴a.脓毒症急性肾损伤患者血清USF2 和THBS1 表达水平及其诊断价值研究[J].现代检验医学杂志,2023,38(06):98-102+184.[doi:10.3969/j.issn.1671-7414.2023.06.018]
　ZHAO Ruichena,CHEN Chunyanb,HE Qina.Study on the Expression Levels and Diagnostic Value of Serum USF2 and THBS1 in Patients with Sepsis and Acute Kidney Injury[J].Journal of Modern Laboratory Medicine,2023,38(06):98-102+184.[doi:10.3969/j.issn.1671-7414.2023.06.018]
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脓毒症急性肾损伤患者血清USF2 和THBS1 表达水平及其诊断价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
98-102+184
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Study on the Expression Levels and Diagnostic Value of Serum USF2 and THBS1 in Patients with Sepsis and Acute Kidney Injury
文章编号:
1671-7414（2023）06-098-06
作者:
赵瑞臣a; 陈春燕b; 何 琴a
（中国人民解放军西藏军区总医院a. 急诊医学科；b. 检验科，拉萨 850007）
Author(s):
ZHAO Ruichena;  CHEN Chunyanb;  HE Qina
（a. Department of Emergency; b. Department of Clinical Laboratory, the General Hospital of Tibet Military Region of the Chinese People’s Liberation Army, Lhasa 850007，China）
关键词:
脓毒症; 急性肾损伤; 上游刺激因子2; 血小板反应蛋白-1
分类号:
R631；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.018
文献标志码:
A
摘要:
目的 探讨血清上游刺激因子2（upstream stimulatory factor 2，USF2）和血小板反应蛋白- 1（thrombospondin-1，THBS1）对脓毒症急性肾损伤（acute kidney injury，AKI）的诊断价值。方法 选取2020 年10 月～ 2022 年10 月中国人民解放军西藏军区总医院收治的109 例脓毒症患者，分为AKI 组（n=45）和非AKI 组（n=64）。收集患者临床资料，检测两组血清USF2 和THBS1 水平，Pearson 分析血清USF2 和THBS1 与脓毒症患者肾功能指标的相关性。多因素Logistic 回归分析脓毒症AKI 的危险因素，受试者工作特征（ROC）曲线分析血清USF2 和THBS1 对脓毒症AKI 的诊断效能。结果 AKI 组血清尿素氮（blood urea nitrogen，BUN）、肌酐（serum creatinine，sCr）、胱抑素C（cystatin C，Cys C）、C 反应蛋白、降钙素原水平、急性生理与慢性健康状况评分Ⅱ评分、序贯器官衰竭评分（sequential organ failureassessment，SOFA）高于非AKI 组，差异均有统计学意义（t=20.983，33.063，10.641，6.735，7.472，8.487，10.578，均P ＜0.05）。AKI 组血清USF2（3.26±1.04 vs 1.27±0.36 ）和THBS1 水平（172.35±53.19 ng/ml vs 103.64±32.56 ng/ml）高于非AKI 组，差异有统计学意义（t=14.171，8.353，均P ＜ 0.05）。AKI 患者血清USF2，THBS1 与BUN，sCr，CysC 呈正相关（r =0.619，0.507，0.432；0.596，0.607，0.547，均P ＜ 0.05）。高SOFA 评分[OR(95%CI)=3.170（1.754 ～ 5.731）]、高USF2[OR(95%CI)=1.680（1.116 ～ 2.531）]、高THBS1[OR(95%CI)=1.603（1.113 ～ 2.308）] 是发生脓毒症AKI 的危险因素（均P ＜ 0.05）。血清USF2，THBS1 及二者联合诊断脓毒症AKI 的曲线下面积分别为0.778（95%CI: 0.689 ～ 0.852），0.755（95%CI: 0.663 ～ 0.832）和0.947（95%CI: 0.887 ～ 0.981）。结论 脓毒症AKI 患者血清USF2 和THBS1 水平均显著增高，且与肾功能下降以及AKI 的发生有关，可用于辅助诊断脓毒症AKI。
Abstract:
Objective To investigate the diagnostic value of serum upstream stimulatory factor-2 (USF2) and thrombospondin-1 (THBS1) in acute kidney injury (AKI) in sepsis. Methods 109 sepsis patients admitted to the General Hospital of Tibet Military Region of the Chinese People’s Liberation Army from October 2020 to October 2022 were selected and divided into AKI group （n=45）and non AKI group （n=64）.Clinical data of patients were collected and serum levels of USF2 and THBS1 were measured in two groups, pearson analysis was conducted to investigate the correlation between serum USF2 and THBS1 and renal function indicators in sepsis patients. Multivariate logistic regression analysis was used to identify the risk factors for sepsis associated AKI, and the diagnostic efficacy of serum USF2 and THBS1 in sepsis associated AKI was analyzed using the subject's working characteristic curve. Results The levels of serum urea nitrogen (BUN), serum creatinine (sCr), cystatin C (Cys C), C-reactive protein, procalcitonin, acute physiological and chronic health status score II, and sequential organ failure assessment (SOFA)in AKI group were higher than those in non AKI group, and the difference was statistically significant (t=20.983, 33.063, 10.641, 6.735, 7.472, 8.487, 10.578, all P<0.05). The serum levels of USF2 (3.26 ± 1.04 vs 1.27 ± 0.36) and THBS1 (172.35 ± 53.19 ng/ml vs 103.64 ± 32.56 ng/ml) in the AKI group were higher than those in the non AKI group, and the difference was statistically significant (t=14.171, 8.353, all P<0.05).The serum levels of USF2 and THBS1 in AKI patients were positively correlated with BUN, sCr and CysC (r=0.619, 0.507, 0.432; 0.596, 0.607, 0.547, all P<0.05).High SOFA score [OR (95% CI)=3.170 (1.754 ～ 5.731)], high USF2 [OR (95% CI)=1.680 (1.116 ～ 2.531)], and high THBS1 [OR (95% CI)=1.603 (1.113 ～ 2.308)] were risk factors for sepsis AKI (all P<0.05).The area under the curve of serum USF2, THBS1 and their combination in diagnosing sepsis AKI were 0.778 (95% CI: 0.689~0.852), 0.755 (95% CI: 0.663~0.832) and 0.947 (95% CI: 0.887~0.981), respectively. Conclusion The serum levels of USF2 and THBS1 in sepsis AKI patients were significantly increased, and were related to decreased renal function and the occurrence of AKI, which can be used as an auxiliary diagnosis for sepsis AKI.

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备注/Memo

备注/Memo:
基金项目：西藏自治区科技计划项目（XZ2019ZRG-122）：TGF-B/SMAD 信号通路参与脓毒症急性肾损伤的机制。
作者简介： 赵瑞臣（1980-），男，本科，副主任医师，研究方向：创伤早期急救、心肺复苏、重症感染、重症血液净化、多脏器功能衰竭等急危重症救治，E-mail：ruicheng4125@163.com。
更新日期/Last Update: 2023-11-15