钙卫蛋白和IL-18对脓毒症合并急性肾损伤的早期诊断价值

Value of calprotectin and IL-18in early diagnosis of sepsis complicated with acute kidney injury

目的探讨钙卫蛋白和IL-18对脓毒症合并急性肾损伤(AKI)的早期诊断价值。方法脓毒症住院患者61例;其中,31例合并AKI(AKI组),30例无AKI(非AKI组)。比较两组血、尿钙卫蛋白和IL-18的水平。采用ROC曲线评价钙卫蛋白和IL-18对脓毒症患者合并AKI的早期诊断价值。结果AKI组血钙卫蛋白和IL-18水平高于非AKI组[(152.60±42.68)ng/ml vs.(130.32±34.78)ng/ml和(57.82±34.52)pg/ml vs.(38.74±19.53)pg/ml](P<0.05),尿钙卫蛋白和IL-18水平也高于非AKI组[(158.90±62.17)ng/ml vs.(84.70±37.19)ng/ml和(25.38±14.48)pg/ml vs.(14.62±6.89)pg/ml](P<0.05)。血钙卫蛋白、尿钙卫蛋白、血IL-18和尿IL-18诊断脓毒症合并AKI的AUC分别为0.655[(95%CI(0.522～0.772)]、0.883[95%CI(0.715～0.916)]、0.663[95%CI(0.531～0.779)]和0.774[95%CI(0.649～0.871)]。结论血、尿钙卫蛋白和IL-18水平均能较好地预测脓毒症合并AKI,尿钙卫蛋白和IL-18水平的诊断价值更好。

Objective To study the value of calprotectin and IL-18 in early diagnosis of sepsis complicated with acute kidney injury（AKI）.Methods Calprotectin and IL-18 in blood and urine were detected in 61 patients with sepsis,of whom 31 patients were complicated with AKI（group A）and 30 patients were without（group B）.ROC curve analysis was employed to evaluate the prediction value of calprotectin and IL-18 in early diagnosis of sepsis complicated with AKI.Results Blood levels of calprotectin and IL-18 were higher in group A than those in group B [（152.60±42.68）ng/ml vs.（130.32±34.78）ng/ml and（57.82±34.52）pg/ml vs.（38.74±19.53）pg/ml]（P〈0.05）.So did urinary levels of calprotectin and IL-18[（158.90±62.17）ng/ml vs.（84.70±37.19）ng/ml and（25.38±14.48）pg/ml vs.（14.62±6.89）pg/ml]（P〈0.05）.The areas under the ROC curves for blood calprotectin,urinary calprotectin,blood IL-18 and urinary IL-18 in diagnosing sepsis complicated with AKI were 0.655 [95%CI（0.522-0.772）],0.883 [95%CI（0.715-0.916）],0.663 [95%CI（0.531-0.779）]and 0.774 [95%CI（0.649-0.871）],respectively.Conclusion Blood and urinary calprotectin and IL-18 levels have better value in predicting AKI in the patients with sepsis,in which the early diagnostic efficiency of urinary calprotectin and IL-18 is better than that of blood.