血红素加氧酶-1对脓毒症急性肾损伤的预测价值

Predictive value of HO-1 for sepsis-induced acute kidney injury

目的探讨血红素加氧酶-1(HO-1)对脓毒症急性肾损伤(AKI)的预测价值。方法选取2017年1月~2018年1月我院急诊科收治的151例临床诊断脓毒症(sepsis)患者,以"KDIGO-AKI"为标准分为肾损伤组(54例)和非肾损伤组(97例),采用受试者工作特征曲线评价观察指标的预测价值。结果肾损伤组入科后6 h的血浆HO-1、液体正平衡量、尿素氮、尿β2微球蛋白、尿微量清蛋白均高于非肾损伤组,差异均有统计学意义(P<0.05)。两组尿量比较,差异无统计学意义(P>0.05)。入科后6 h时血浆HO-1、液体正平衡量两者ROC曲线下面积分别为0.891、0.857。入科后6 h血浆HO-1对AKI的预测价值优于液体正平衡量。当入科后6 h血浆HO-1为1915.5 pg/ml时,敏感度和特异度分别为96.3%和72.2%。结论入科后6 h血浆HO-1是预测AKI的良好指标。当入科后6 h血浆HO-1为1915.5 pg/ml时,敏感度和特异度分别为96.3%和72.2%。

Objective To explore the ability of HO-1 in predicting sepsis-induced acute kidney injury.Methods 151 patients with sepsis in our department were enrolled from January 2017 to January 2018. The patients were divided into kidney injury group（AKI group, 54 cases） and no kidney injury group（no AKI group,97 cases）, according to the situation of acute kidney injury. Receiver operator characteristic curves were generated and the area under the curve was compared. Results HO-1, positive fluid balance, BUN, urinary β2-microglobulin, urinary microalbumin after 6 hours in AKI group were significantly higher than those in no AKI group（P〈0.05）. Area under ROC of HO-1 and positive fluid balance after 6 hours were 0.891 and 0.857. With a cutoff value of 1915.5 pg/ml, HO-1 had a sensitivity of 96.3% and a specificity of 72.2%. Conclusion HO-1 is a good index to predict sepsis-induced acute kidney injury. With a cutoff value of 1915.5 pg/ml, HO-1 has a sensitivity of 96.3% and a specificity of 72.2%.