循环ciRs-126水平与脓毒症患者急性肾损伤的相关性

Relationship between ciRs-126 and Acute Kidney Injury in Patients with Sepsis

【目的】探讨循环ciRs-126水平与脓毒症患者急性肾损伤(AKI)的相关性。【方法】本院收治的80例脓毒症患者,根据肾功能损伤程度分为AKI组(30例)和未发生AKI组(50例),比较两组临床资料、病情评分及循环ciRs-126水平。【结果】两组年龄、性别、体重指数(BMI)、基础合并症、吸烟史、饮酒史比较,差异均无统计学意义(P>0.05);两组肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)水平比较,差异无统计学意义(P>0.05);AKI组患者血肌酐(Scr)、血清尿素氮(BUN)水平均高于未发生AKI组,肾小球滤过率(eGFR)水平低于未发生AKI组(P<0.05);AKI组序贯器官功能衰竭评分(SOFA)、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)均高于未发生AKI组(P<0.05),循环ciRs-126水平高于未发生AKI组(P<0.05);经受试者工作特征(ROC)曲线分析证明,Scr、eGFR、SOFA、APACHEⅡ、循环ciRs-126均可用于脓毒症后发生AKI的预测,曲线下面积分别为0.725、0.800、0.687、0.751、0.785(均P<0.05);多因素Logistic回归分析结果显示,Scr≥156.70μmol/L、eGFR≤84.58 mL/min、SOFA≥13.24分、APACHEⅡ≥29.26分、循环ciRs-126≥3.76是脓毒症后发生AKI的危险因素(P<0.05)。【结论】在脓毒症患者中循环ciRs-126水平升高可预测AKI的发生,应加强此项指标的监测。

【Objective】To investigate the correlation between ciRs-126 and acute kidney injury(AKI)in patients with sepsis.【Methods】Eighty patients with sepsis admitted to our hospital were divided into two groups according to the degree of renal injury:AKI group(30 cases)and non-AKI group(50 cases).General information,disease score and ciRs-126 levels of the two groups were compared.【Results】There were no differences in age,sex,body mass index(BMI),underlying complications,smoking history and drinking history between the two groups(P>0.05).There were no differences in tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)levels between the two groups(P>0.05).Serum creatinine(Scr)and serum urea nitrogen(BUN)levels in the AKI group were higher than that in the non-AKI group,while the glomerular filtration rate(eGFR)level in the AKI group was lower than that in non-AKI group(P<0.05).The sequential organ failure score(SOFA)and acute physiological and chronic health score(APACHEⅡ)in the group with AKI were higher than those in the group without AKI(P<0.05).The level of ciRs-126 in the group with AKI was higher than that in the group without AKI(P<0.05).ROC analysis showed that Scr,eGFR,SOFA,APACHEⅡand ciRs-126 could be used to predict occurrence of AKI after sepsis,and the areas under the curve were 0.725,0.800,0.687,0.751 and 0.785,respectively,(P<0.05).Multivariate Logistic regression analysis confirmed that Scr≥156.70μmol/L,eGFR≤84.58 mL/min,SOFA≥13.24 scores,APACHEⅡ≥29.26 scores,ciRs-126≥3.76 were risk factors for AKI after sepsis(P<0.05).【Conclusion】The increase of ciRs-126 level can predict the occurrence of AKI in patients with sepsis.It is necessary to strengthen the monitoring of this index.