摘要
目的探讨脓毒症患者血清血管生成素2(angiopoietin-2,Ang-2)、白细胞介素23(interleukin-23,IL-23)表达情况,并分析其与脓毒症患者发生急性肾损伤(acute kidney injury,AKI)的关系。方法选择承德医学院附属医院收治的脓毒症患者185例作为研究对象。所有患者均进行治疗,根据患者住院期间AKI发生情况分为发生AKI组与未发生AKI组。采用酶联免疫吸附法检测患者入院时血清Ang-2、IL-23水平,并统计患者基线资料,比较2组血清Ang-2、IL-23及基线资料,采用Logistic回归性分析检验影响脓毒症患者并发AKI的影响因素,再绘制受试者工作曲线(receiver operating curve,ROC)探究血清Ang-2、IL-23对脓毒症患者并发AKI的预测价值。结果185例脓毒症患者,经血液及尿液检查,确诊发生AKI 87例,发生率为47.03%;发生AKI组合并休克患者占比高于未发生AKI组,入院时血清Ang-2、IL-23水平高于未发生AKI组,差异有统计学意义(P<0.05);采用二分类Logistic回归分析结果显示,合并休克、入院时Ang-2、IL-23高表达是脓毒症患者发生AKI的危险因素(OR>1,P<0.05);绘制ROC曲线结果显示,血清Ang-2、IL-23水平及联合检测脓毒症患者发生AKI的AUC均>0.70,有一定预测价值,其中联合检测最高;血清Ang-2、IL-23水平与脓毒症患者发生AKI的关联强度呈线性剂量反应关系(P<0.05);血清Ang-2、IL-23水平与脓毒症患者发生AKI呈正相关,特别当血清Ang-2>9.23μg/L、血清IL-23>101.97 pg/L时,脓毒症患者发生AKI风险随血清Ang-2、IL-23水平的升高而升高。结论血清Ang-2、IL-23是影响脓毒症患者发生AKI的影响因素,且AKI发生风险与Ang-2、IL-23水平呈正相关。
Objective To investigate the expression of serum angiopoietin-2(Ang-2)and interleukin-23(IL-23)in patients with sepsis and to analyze their relationship with acute kidney injury(AKI)in patients with sepsis.Methods A total of 185 patients with sepsis treated in the Affiliated Hospital of Chengde Medical College,Hebei Province,were selected as the research subjects.All patients were treated and divided into AKI group and non-AKI group according to the occurrence of AKI during hospitalization.The levels of serum Ang-2 and IL-23 were detected by enzyme-linked immunosorbent assay(ELISA)at admission,and the baseline data of patients were collected.The serum Ang-2,IL-23 and baseline data were compared between the two groups.Logistic regression analysis was used to test the influencing factors of AKI in patients with sepsis,and then the receiver operating curve(ROC)was drawn to explore the predictive value of serum Ang-2 and IL-23 for AKI in patients with sepsis.Results Among 185 patients with sepsis,87 patients with AKI were diagnosed by blood and urine examination,and the incidence rate was 47.03%.The proportion of patients with combined shock was higher in AKI group than in non-AKI group,and the levels of serum Ang-2 and IL-23 at admission were higher than those in non-AKI group,with significant differences(P<0.05).The results of binary Logistic regression analysis showed that combined shock,high expression of Ang-2 and IL-23 at admission were risk factors for AKI in patients with sepsis(OR>1,P<0.05).The ROC curve was drawn,and the results showed that,the area under the ROC curve(AUC)of the levels of serum Ang-2,IL-23 alone and in combination in predicting AKI in patients with sepsis was all>0.70,showing certain predictive value,among which the combined detection was the highest.There was a linear dose-response relationship between the levels of serum Ang-2 and IL-23 and AKI in patients with sepsis(P<0.05).The levels of serum Ang-2 and IL-23 were positively correlated with AKI in patients with sepsis,especially when serum Ang-2 was>9.23μg/L and serum IL-23 was>101.97 pg/L.The risk of AKI in patients with sepsis was increased with the increase of serum Ang-2 and IL-23 levels.Conclusion Serum Ang-2 and IL-23 are the influencing factors of AKI in patients with sepsis,and the risk of AKI is positively correlated with Ang-2 and IL-23 levels.
作者
史东剑
段立娟
赵大铭
张坤
SHI Dong-jian;DUAN Li-juan;ZHAO Da-ming;ZHANG Kun(Department of Critical Care Medicine,the Affiliated Hospital of Chengde Medical College,Hebei Province,Chengde 067000,China;Department of Internal Medicine,Hebei Shangbancheng Prison Hospital,Chengde 067000,China)
出处
《河北医科大学学报》
CAS
2024年第8期974-979,共6页
Journal of Hebei Medical University
基金
承德市科学技术研究与发展计划项目(202109A032)。
作者简介
史东剑(1989-),女,蒙古族,河北承德人,承德医学院附属医院主治医师,医学硕士,从事重症医学研究;通信作者:张坤,E-mail:cyfyzk2002@126.com。
