脓毒症合并急性肾损伤患者外周血USF2、USP10表达水平及临床意义

Expression levels of USF2 and USP10 in peripheral blood of patients with sepsis complicated with acute kidney injury and their clinical significance

目的 探讨脓毒症合并急性肾损伤(AKI)患者外周血上游转录因子2(USF2)、泛素特异性蛋白酶10(USP10)的表达水平及临床意义。方法 选择2018年1月至2022年12月该院收治的259例脓毒症患者,根据是否合并AKI将患者分为AKI组(107例)和非AKI(NAKI)组(152例)。收集临床一般资料,检测外周血中USF2、USP10的表达水平。Pearson分析USF2、USP10与肾功能的相关性。二元Logistic回归分析影响脓毒症患者合并AKI的因素。绘制受试者工作特征(ROC)曲线分析USF2、USP10诊断脓毒症患者合并AKI的价值。结果 AKI组血清USF2表达水平高于NAKI组,差异有统计学意义(P<0.05),USP10表达水平低于NAKI组,差异有统计学意义(P<0.05)。AKI组USF2表达与尿素氮(BUN)、血清肌酐(Scr)、胱抑素C(CysC)呈正相关(P<0.05),USP10表达与BUN、Scr、CysC呈负相关(P<0.05)。高序贯器官衰竭(SOFA)评分、脓毒症休克、高表达USF2是脓毒症患者发生AKI的危险因素(P<0.05),高表达USP10是保护因素(P<0.05)。USF2、USP10诊断脓毒症患者发生AKI的曲线下面积(AUC)分别为0.742(95%CI:0.676~0.808)、0.781(95%CI:0.724~0.839),联合USF2和USP10诊断脓毒症患者发生AKI的AUC为0.907(95%CI:0.865~0.948),高于单独诊断(P<0.05)。结论 脓毒症患者外周血中USF2表达增加,USP10表达下降与合并AKI风险增加以及肾功能下降有关。

Objective To investigate the expression levels and the clinical significance of upstream transcription factor 2(USF2)and ubiquitin-specific protease 10(USP10)in peripheral blood of patients with sepsis combined with acute kidney injury(AKI).Methods A total of 259 patients with sepsis were selected from Jilin Provincial People′s Hospital from January 2018 to December 2022.Patients were divided into AKI group(107 cases)and non AKI(NAKI)group(152 cases)according to whether they had AKI or not.General clinical data were collected and the expression levels of USF2 and USP10 in peripheral blood were detected.Pearson analysis was used to investigate the correlation between USF2,USP10,and renal function.Binary Logistic regression analysis was used to investigate the factors influencing sepsis patients with AKI.Receiver operating characteristic(ROC)curve was drown to analyze the value of USF2 and USP10 in diagnosing AKI in patients with sepsis.Results The expression level of serum USF2 in AKI group was higher than that in NAKI group,and the difference was statistically significant(P<0.05),while the serum USP10 expression level in AKI group was lower than that in NAKI group,and the difference was statistically significant(P<0.05).In AKI group,USF2 expression was positively correlated with urea nitrogen(BUN),serum creatinine(Scr)and Cystatin C(CysC)(P<0.05),while USP10 expression was negatively correlated with BUN,Scr and CysC(P<0.05).High sequential organ failure assessment(SOFA)score,septic shock and high expression of USF2 were risk factors for AKI in sepsis patients(P<0.05),and high expression of USP10 was protective factor(P<0.05).The area under the curve(AUC)of single detection of USF2 and USP10 for diagnosing AKI in patients with sepsis was 0.742(95%CI:0.676-0.808)and 0.781(95%CI:0.724-0.839),respectively.The AUC of the combination of USF2 and USP10 for diagnosing AKI in patients with sepsis was 0.907(95%CI:0.865-0.948),which was higher than that of single detection(P<0.05).Conclusion Increased expression of USF2 and decreased expression of USP10 in peripheral blood of patients with sepsis are associated with increased risk of AKI and decreased renal function.