尿血管紧张素原在CRRT治疗急性肾损伤中的预测作用

The predictive role of urinary angiotensinogen in CRRT treatment of acute kidney injury

目的探讨尿血管紧张素原在CRRT治疗急性肾损伤中的预测作用。方法选择2017年11月至2019年4月本院收治的急性肾功能损伤行持续血液滤过治疗者80例,按照入组时尿血管紧张素原水平是否异常分为两组,其中观察组为尿血管紧张素原水平升高,对照组为尿血管紧张素原水平正常。搜集所有入组者临床资料,主要包括性别、年龄、病程、入组时肾小球滤过率、尿蛋白、尿素氮、血肌酐及血尿酸水平等,比较两组患者肾功能恢复正常时间及总住院时间,两组患者CRRT干预前后肾小球滤过率及尿蛋白水平,分析尿血管紧张素原与治疗过程中患者肾功能相关指标的相关性。结果观察组肾功能恢复正常时间及住院时间均显著短于对照组,差异有统计学意义(P<0.05)。干预前两组肾小球滤过率及尿蛋白水平比较,差异无统计学意义(P>0.05),干预后观察组肾小球滤过率高于干预前及干预后对照组,尿蛋白水平均显著低于干预前及干预后对照组,差异有统计学意义(P<0.05)。尿血管紧张素原水平与治疗过程中患者肾功能相关指标,如尿素氮、肌酐及血尿酸水平均呈正相关(P<0.05)。结论急性肾损伤患者尿血管紧张素原水平的升高其病情较重、住院时间较长,且与患者肾功能恢复存在一定相关性。

Objective To explore the predictive role of urinary angiotensinogen in CRRT treatment of acute kidney injury.Methods A total of 80 patients with acute renal function injury who underwent continuous hemofiltration treatment in our hospital from November 2017 to April 2019 were selected and divided into two groups according to whether the level of urinary angiotensinogen was abnormal at the time of enrollment.The level of urinary angiotensinogen in the observation group was elevated,and the level of urinary angiotensinogen in the control group was normal.The clinical data of all enrolled patients were collected,mainly including gender,age,course of disease,glomerular filtration rate,urine protein,urea nitrogen,blood creatinine and blood uric acid levels at enrollment,etc.The time for kidney function to return to normal and total hospital stay,the glomerular filtration rate and urine protein levels of the two groups before and after CRRT intervention were compared.The correlation between urinary angiotensinogen and renal function-related indicators during treatment were analyzed.Results The time for kidney function to return to normal and hospital stay in the observation group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the glomerular filtration rate and urine protein level between the two groups before the intervention(P>0.05).The glomerular filtration rate in the observation group after the intervention were significantly higher than that before the intervention and in the control group after the intervention,and the urine protein level in the obervation group was lower than that before the intervention and in the control group after the intervention.The differences were statistically significant(P<0.05).Urinary angiotensinogen level was positively correlated with the renal function-related indexes of patients during treatment,such as urea nitrogen,creatinine and blood uric acid level,and the difference was statistically significant(P<0.05).Conclusion In patients with acute kidney injury,those with elevated levels of urinary angiotensinogen are more severely ill,have a longer hospital stay,and are related to the recovery of renal function.