心衰合并急性肾衰竭患者尿L-FABP、IL-18表达与预后的相关性

Correlation between the expressions of urinary L-FABP,serum IL-18 and the prognosis of patients with heart failure complicated by acute renal failure

目的检测心衰合并急性肾衰竭(ARF)患者尿肝型脂肪酸结合蛋白(L-FABP)、白细胞介素-18(IL-18)表达情况,分析二者与预后的相关性。方法选择2012年6月至2016年6月收治的心衰合ARF患者112例作为观察组,选择同期体检的健康者90例作为对照组,采用酶联免疫吸附(ELISA)法检测尿L-FABP及IL-18水平,所有患者每半年随访1次,调查并记录患者随访期间内发病情况、再住院情况及死亡情况。结果观察组心衰合并ARF患者尿L-FABP、IL-18水平均高于对照组(P<0.05);Ⅳ级心功能级别患者尿L-FABP、IL-18水平显著高于Ⅱ、Ⅲ级患者,Ⅲ级心功能级别患者显著高于Ⅱ级患者(P<0.05);2年随访结束后,患者死亡16例(14.29%),未死亡96例(85.71%);尿L-FABP、IL-18高表达组患者死亡、再次住院及未住院发生率显著高于低表达组(P<0.05);患者尿L-FABP与IL-18水平表达呈明显正相关。结论心衰合并ARF患者尿L-FABP、IL-18高表达,与患者心功能级别、预后情况有关,可能作为预测及评估心衰合并ARF患者预后情况的指标。

Objective To detect the expressions of urinary L-FABP and serum IL-18 in patients with heart failure complicated by acute renal failure,and to analyze their correlations with prognosis of patients.Methods A total of 112 patients with heart failure complicated by acute renal failure admitted who were admitted and treated in our hospital from June 2012 to June 2016 were enrolled as observation group,at the same time,90 healthy subjects who underwent physical examination in our hospital were enrolled as control group.The enzyme linked immunosorbent assay(ELISA)was used to detect the levels of urinary L-FABP and serum IL-18,and all the patients were followed up once every six months,the incidence of disease,rehospitalization status and death of patients during follow up were observed and compared between the two groups.Results The levels of urinary L-FABP and serum IL-18 in observation group were significantly higher than those in control group(P<0.05).The levels of urinary L-FABP and serum IL-18 in gradeⅣpatients were significantly higher than those in gradeⅡandⅢpatients,which in gradeⅢpatients were significantly higher than those in gradeⅡpatients(P<0.05).After 2-year follow up,16 patients died(14.29%),and 96 patients were survival(85.71%).Moreover the incidences of death,rehospitalization and non-hospitalization in patients with high expressions of urinary L-FABP and serum IL-18 were significantly higher than those in patients with low expressions of urinary L-FABP and serum IL-18(P<0.05).In addition there was a positive correlation between the expression levels of urinary L-FABP and those of IL-18.Conclusion The high expressions of L-FABP and IL-18 are related to the cardiac function and prognosis of patients with heart failure complicated by acute renal failure,which can be regarded as the indexes to predict patient’s prognosis.