miRNA-21联合尿KIM-1评价多发伤合并急性肾损伤患者预后的临床研究

Clinical Study of MicroRNA21 Combined with Urinary KIM-1 in Evaluating Prognosis of Patients with Multiple Trauma and Acute Kidney Injury

目的:探讨miRNA-21联合肾损伤分子1(kidney injury molecule-1,KIM-1)评价多发伤合并急性肾损伤患者预后的临床价值。方法:选择我院2017年1月-2020年12月收治的46例多发伤并急性肾损伤患者为观察组,另在我院健康体检中心采集20例正常健康人为对照组,采集血液标本后检测2组患者血清miRNA-21、肌酐、尿KIM-1水平。结果:观察组患者相对于健康对照组,其血清miRNA-21、肌酐、尿KIM-1水平明显升高,差异具有统计学意义(P<0.05),miRNA21以及KIM-1对于多发伤合并肾损伤患者的死亡结局具备一定的预测能力,对于miRNA-21升高(≥6.7),游离DNA升高(≥1.5μg/L)两者同时存在预测MODS最准确,相对危险度RR为6.00,特异性达99%。结论:miRNA21以及KIM-1对于多发伤合并肾损伤患者的预后均具备一定的评价能力,但两者联合能更准确的评估多发伤合并肾损伤患者的预后。

Objective:To investigate the clinical value of microRNA-21 combined with kidney injury molecule-1(KIM-1)in evaluating the prognosis of multiple trauma patients with acute renal injury.Methods:46 patients with multiple trauma and acute kidney injury were selected as the study group.Another 20 healthy persons were col-lected from the health examination center of our hospital as the control group.After collecting blood samples,the lev-els of serum microRNA21,creatinine and urinary KIM-1 in the two groups were detected.Results:Compared with the healthy control group,the serum levels of microRNA21,creatinine and urinary KIM-1 increased significantly in the study group(P<0.05).The levels of microRNA21 and KIM-1 could predict the mortality outcome of patients with multiple trauma and kidney injury.The levels of microRNA21(>6.7)and free DNA(>1.5 ug/L)could predict MODS at the same time.The relative risk RR was 6.00 and the specificity was 99%.Conclusion:Both mi-croRNA21 and KIM-1 have certain ability to evaluate the prognosis of patients with multiple trauma and renal inju-ry,but the combination of them can more accurately evaluate the prognosis of patients with multiple trauma and renal injury.