脓毒症肾损伤患者血清血管内皮钙粘蛋白水平变化及临床意义

Changes of Serum Vascular Endothelial Cadherin Levels In Patients With Septic Kidney Injury And Its Clinical Significance

目的:通过检测脓毒症急性肾损伤患者血清血管内皮钙粘蛋白(vascular endothelial cadherin,VE-cadherin)的水平变化,探讨其临床意义。方法:收集2020年1月至2022年12月期间急诊医学科收治的140例脓毒症患者为研究对象,根据是否发生急性肾损伤分为脓毒症(sepsis)组和脓毒症肾损伤(Sepsis-related acute kidney injury,SAKI)组,收集相关资料,采用酶联免疫吸附试验(ELISA)检测入院24小时内血清VE-cadherin水平,分析其与血肌酐(Scr)、降钙素原(PCT)、APACHEⅡ评分、SOFA评分相关性。绘制受试者工作特征曲线(ROC曲线)评价VE-cadherin对SAKI的预测价值。结果:脓毒症AKI组患者血清VE-cadherin水平高于对照组组,差异具有统计学意义(P<0.05);脓毒症AKI组患者血清VE-cadherin水平与Scr、PCT、SOFA评分、APACHEⅡ呈正相关,r值分别为0.812、0.823、0.798、0.845,P均<0.05,差异有统计学意义(P<0.05)。VE-cadherin对SA-AKI有一定预测价值(P<0.05),ROC曲线下面积(AUC)为0.798;VE-cadherin≥7.25μg/mL时,敏感度为0.839%,特异度为72.5%。结论:SAKI患者的血清VE-cadherin水平高于脓毒症组,其与Scr、PCT、SOFA评分、APACHEⅡ呈正相关。VE-cadherin对SAKI具有一定的预测价值。

Objective:To investigate the clinical significance of serum vascular endothelial cadherin(VE-cad-herin)in patients with sepsis acute kidney injury.Methods:140 patients with sepsis admitted to the Department of Emergency Medicine from January 2020 to December 2022 were collected as research objects.They were divided into the Sepsis group and the Sepsis-related acute kidney injury group according to whether they had acute kidney injury.Serum VE-cadherin level within 24 hours after admission was detected by enzyme-linked immunosorbent assay(ELISA).The correlation between VE-cadherin with serum creatinine(Scr),procalcitonin(PCT),APACHE Ⅱ score and SOFA score was analyzed.The receiver operating characteristic curve(ROC curve)was plotted to evaluate the predictive value of VE-cadherin for SAKI.Results:Serum VE-cadherin level in AKI group was higher than that in sepsis group,the difference was statistically significant(P<0.05);Serum VE-cadherin level in sepsis AKI group was positively correlated with Scr,PCT,SOFA score and APACHE Ⅱ.The R values is 0.812,0.823,0.798 and 0.845,respectively,and the difference was statistically significant.3.VE-cadherin had certain predictive value for SA-AKI,and the area under ROC curve was 0.798.When VE-cadherin was≥7.25μg/mL,the sensitivity was 0.839%and the specificity was 72.5%.Conclusion:Serum VE-cadherin level in AKI patients with sepsis was higher than that in sepsis group,and it was positively correlat-ed with Scr,PCT,SOFA score and APACHE II.VE-cadherin had certain predictive value for SAKI.