血、尿IL-18和KIM-1联合检测对冠心病患者行介入术后急性肾损伤的早期诊断意义
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Significance of interleukin 18 and kidney injury molecule 1 in serum and urine in early diagnosis of patients with acute kidney injury after coronary intervention
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    摘要:

    目的:探讨分析血、尿白细胞介素-18(interleukin 18 ,IL-18)和肾损伤分子-1(kidney injury molecule 1,KIM-1)联合检测在冠心病介入术后急性肾损伤( acute kidney injury,AKI) 早期诊断中的价值。方法:选取河南省平顶山市第二人民医院心内科收治的诊断为冠心病并行介入术治疗的患者243例,分为AKI组48例,非AKI组195例;收集所有患者术后0、2、4、6、8、10、12、24、48、72 h血液及尿液样本,检测各时间点血液样本的血清肌酐(serum creatinine,SCr)、IL-18和KIM-1,尿液样本的IL-18和KIM-1水平。结果:AKI组患者术后12、24、48、72 h SCr值均明显高于0 h基线值(P均<0.05);AKI组术后各时间点血、尿IL-18和KIM-1水平均高于0 h基线值,IL-18在2 h(血)或4 h(尿)时达到峰值,KIM-1在6 h(血)或8 h(尿)时达到峰值(P均<0.05);Pearson相关分析显示,AKI组术后血(2 h)、尿(4 h)IL-18和血(6 h)、尿(8 h)KIM-1水平均与术后24 h SCr呈正相关(P均<0.05);ROC曲线分析显示,血(2 h)、尿(4 h)IL-18和血(6 h)、尿(8 h)KIM-1 ROC曲线下面积(AUC)对AKI的诊断均具有较好的诊断效能;血(2 h)、尿(4 h)IL-8和血(6 h)、尿(8 h)KIM-1联合检测诊断AKI的AUC均大于两者的单独检测。结论:对冠心病患者进行介入术后的2 h血IL-18、4 h尿IL-18、6 h血KIM-1、8 h尿KIM-1的联合检测,对早期诊断AKI具有良好的诊断效能,有一定的诊断价值,其或可成为早期诊断AKI的重要参考依据。

    Abstract:

    Objective:To investigate the value of interleukin 18 (IL-18) and urinary kidney injury molecule 1 (KIM-1) in blood and urine in early diagnosis of acute kidney injury (AKI) after coronary intervention. Methods: A total of 243 eligible patients who underwent coronary intervention were divided into the AKI group (48 cases) and the non-AKI group (195 cases) according to the diagnostic criteria of AKI. Blood and urine samples were collected at different time points (0, 2, 4, 6, 8, 10, 12, 24, 48, and 72 h) after coronary intervention, and then the concentrations of serum creatinine(SCr), IL-18 and KIM-1 in serum and urine were measured. Results: The levels of SCr from 12 h to 72 h were higher than that of 0 h in the AKI group(all P<0.05). The levels of IL-18 and KIM in serum and urine were significantly higher than those of 0 h. IL-18 level reached peak at 2 h(blood) or 4 h(urine), and KIM-1 level reached peak at 6 h (blood) or 8 h (urine) (all P<0.05). Pearson correlation analysis showed the levels of 2 h-serum IL-18, 4 h-urine IL-18, 6 h-serum KIM-1 and 8 h-urine KIM-1 were positively correlated with that of SCr(24 h) (all P<0.05). The ROC analysis showed the levels of IL-18 and KIM-1 in serum and urine had a good diagnostic efficiency. The joint detection had a higher AUC than single marker detection. Conclusion: The joint detection of 2 h-serum IL-18, 4 h-urine IL-18, 6 h-serum KIM-1 and 8 h-urine KIM-1 after intervention had a better diagnostic performance than single marker detection, which may be an important reference for early diagnosis of AKI.

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李 恭,张冬梅.血、尿IL-18和KIM-1联合检测对冠心病患者行介入术后急性肾损伤的早期诊断意义[J].南京医科大学学报(自然科学版),2017,(11):1414-1418

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  • 收稿日期:2016-07-12
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  • 在线发布日期: 2017-12-06
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