外周血KIM-1在肝硬化合并肝肾综合征患者中的表达及意义

The expression and significance of of peripheral KIM-1 levels for early hepatorenal syndrome patients

目的通过分析肝硬化合并肝肾综合征(HRS)患者外周血肾损伤因子-1(KIM-1)水平,探讨KIM-1的早期诊断、预测价值。方法选择肝硬化患者60例(单纯肝硬化患者35例,肝硬化合并HRS患者25例),选择健康体检者30例作对照,比较不同组患者Scr、BUN、eGRF、KIM-1和血清Cys-C水平,分析KIM-1诊断HRS的ROC曲线以及KIM-1水平与Cys-C、Scr和eGRF的相关性。结果随着Child-Pugh分级的上升,患者Scr、BUN、KIM-1和Cys-C水平增高,eGRF水平降低,差异有统计学意义(P<0.05)。合并HRS组患者KIM-1和Cys-C水平均高于单纯肝硬化组,差异有统计学意义(P<0.001)。KIM-1诊断HRS的AUC为0.808(P<0.05)。肝硬化患者血清KIM-1水平与Cys-C、Scr呈正相关;与eGRF呈负相关。结论外周血KIM-1水平能够比较灵敏地反映肝硬化合并肝肾综合征患者的早期肾损害,对其早期诊断、预测有重要的临床价值。

Objective By analyzing the peripheral kidney injury molecule-1 levels of patients with hepatorenal syndrome,to explore the early diagnosis and predictive value of KIM-1.Methods 60 patients of liver cirrhosis （35 patients with cirrhosis alone,25 patients with liver cirrhosis complicated HRS）were selected,and 30 cases of healthy people were selected as control group,Scr,BUN,eGRF,KIM-1 and Cys-C levels were compared in different groups,the ROC curve of KIM-1 diagnosis on HRS patients,correlation analysis of KIM-1 levels and Cys-C,Scr and eGRF were conducted.Results With the rise of the Child-Pugh classification,Scr,BUN,KIM-1 and Cys-C levels increased,and eGRF level reduced,the difference was statistically significant （P 〈0.05）.The KIM-1 and Cys-C levels in combined HRS group were higher than those in cirrhosis group,the difference was statistically significant （P 〈0.001）.The AUC of KIM-1 diagnosis on HRS was 0.808 （P 〈0.05）.Serum KIM-1 and Cys-C,Scr were positively correlated;KIM-1 and eGRF were negative correlated.Conclusion Peripheral blood KIM-1 level is a sensitive response indicator of early renal damage in patients with hepatorenal syndrome,and it has important clinical value for early diagnosis and prediction.