血清胱抑素C、肝素结合蛋白及SOFA评分对脓毒症患者急性肾损伤的诊断价值

Diagnostic Value of Serum Cystatin C,Heparin-binding Protein,and SOFA Score for Acute Kidney Injury in Patients With Sepsis

目的 探讨血清胱抑素C(sCysC)、肝素结合蛋白(HBP)及序贯器官衰竭评分(SOFA评分)在成人脓毒症患者急性肾损伤(SA-AKI)诊断中的应用价值。方法 回顾性分析2020年12月-2022年8月在江苏大学附属武进医院重症医学科收治的76例脓毒症患者,根据患者是否合并急性肾损伤(AKI)分为AKI组(35例)和非AKI组(41例)。比较两组间相关指标,采用Logistic回归分析探讨脓毒症患者急性肾损伤的危险因素,采用受试者工作特征(ROC)曲线分析s CysC、血HBP及SOFA评分对脓毒症患者合并AKI的预测价值。结果 AKI组使用血管活性药物、使用机械通气、s CysC、HBP及SOFA评分均高于非AKI组(P<0.05);其中sCysC、HBP及SOFA评分为影响脓毒症患者并发AKI的独立影响因素(P<0.05);s CysC、HBP、SOFA评分以及3者联合检测预测脓毒症患者并发AKI的AUC依次为0.671、0.710、0.716、0.815,sCysC、HBP及SOFA评分联合AUC较sCysC及HBP的AUC大(P<0.05)。结论 sCysC、HBP联合SOFA评分对SA-AKI患者诊断有较高的临床应用价值,可能为临床上SA-AKI患者的治疗提供参考依据,降低患者不良预后的发生率。

Objective To explore the value of serum cystatin C(sCysC),heparin-binding protein(HBP)and sequential organ failure score(SOFA)in the diagnosis of acute kidney injury(SA-AKI)in adult patients with sepsis.Methods A retrospective analysis was performed on 76 patients with sepsis admitted to the Intensive Care Unit,Wujin Hospital Affiliated to Jiangsu University from December 2020 to August 2022.The patients were divided into AKI group(35 patients)and non-AKI group(41 patients)according to whether they had acute kidney injury(AKI).The related indicators between the two groups were compared.Logistic regression analysis was used to explore the risk factors of acute kidney injury in patients with sepsis.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of sCysC,blood HBP and SOFA scores for AKI in patients with sepsis.Results The proportion of vasoactive drugs,the proportion of mechanical ventilation,sCysC,HBP and SOFA scores in the AKI group were higher than those in the non-AKI group(P<0.05).Among them,sCysC,HBP and SOFA scores were independent factors affecting AKI in patients with sepsis(P<0.05);the AUC of sCysC,HBP,SOFA score and their combined detection in predicting AKI in patients with sepsis were 0.671,0.710,0.716 and 0.815,respectively.The combined AUC of sCysC,HBP and SOFA score was larger than that of sCysC and HBP(P<0.05).Conclusion sCysC,HBP combined with SOFA score have high clinical application value in the diagnosis of SA-AKI patients,which may provide reference for the treatment of SA-AKI patients and reduce the incidence of poor prognosis.