中国现代医学杂志2024，Vol.34Issue(14)：77-82,6.DOI:10.3969/j.issn.1005-8982.2024.14.012
可溶性血栓调节蛋白联合肾损伤分子1对原发性肾病综合征所致急性肾损伤的早期诊断价值
Early diagnostic value of soluble thrombomodulin combined with kidney injury molecule-1 for acute kidney injury caused by primary nephrotic syndrome
摘要
Abstract
Objective To investigate the early diagnostic value of soluble thrombomodulin(sTM)combined with kidney injury molecule-1(KIM-1)for acute kidney injury(AKI)caused by primary nephrotic syndrome(PNS).Methods A total of 177 PNS patients admitted to our hospital from January 2019 to October 2022 were selected and divided into the AKI group(102 cases)and the non-AKI group(75 cases)according to whether AKI occurred.The clinical data and levels of sTM and KIM-1 were compared between the AKI group and the non-AKI group.The levels of sTM and KIM-1 in patients with different AKI stages were also compared.The risk factors for AKI in PNS patients were determined,and the diagnostic performance of sTM and KIM-1 alone and their combination for AKI caused by PNS was analyzed.Results There was no difference in the sex composition,age,BMI,underlying diseases,medication history,and the hemoglobin level between the two groups(P＞0.05).The levels of 24-hour urine protein,uric acid,cystatin C,serum creatinine(Scr),and blood urea nitrogen(BUN)in the AKI group were higher than those in the non-AKI group(P＜0.05),while urine volume,the level of albumin,and estimated glomerular filtration rate(eGFR)in the AKI group were lower than those in the non-AKI group(P＜0.05).The levels of sTM and KIM-1 in the AKI group were higher than those in the non-AKI group.Specifically,the levels of sTM and KIM-1 in patients with stages Ⅲ and Ⅱ AKI were higher than those in patients with stage Ⅰ AKI(P＜0.05),while they were even higher in patients with stage Ⅲ AKI than those in patients with stage Ⅱ AKI(P＜0.05).Multivariable stepwise Logistic regression analysis revealed that high levels of cystatin C[(OR)=2.965(95％CI:1.220,7.207)],eGFR[(OR)=3.340(95％CI:1.374,8.118)],sTM[(OR)=3.089(95％CI:1.271,7.508)],and KIM-1[(OR)=3.016(95％CI:1.241,7.330)]were all risk factors for AKI in PNS patients(P＜0.05).The sensitivities of sTM,KIM-1 and their combination in the diagnosis of AKI caused by PNS were 76.47％(95％CI:66.84％,84.06％),73.53％(95％CI:63.71％,81.55％),and 71.57％(95％CI:61.64％,79.84％),with the specificities being 70.67％(95％CI:58.86％,80.33％),74.66％(95％CI:63.08％,83.69％),and 96.00％(95％CI:87.97％,98.96％),and AUCs being 0.754(95％CI:0.684,0.816),0.783(95％CI:0.717,0.839),and 0.891(95％CI:0.841,0.935).Conclusion The combination of sTM and KIM-1 has a high value in the early diagnosis of AKI caused by PNS.关键词
原发性肾病综合征/可溶性血栓调节蛋白/肾损伤分子-1/急性肾损伤Key words
primary nephrotic syndrome/soluble thrombomodulin/kidney injury molecule-1/acute kidney injury分类
医药卫生引用本文复制引用
林建,王俊贤,殷沛宏,菅宏蕴,叶晴..可溶性血栓调节蛋白联合肾损伤分子1对原发性肾病综合征所致急性肾损伤的早期诊断价值[J].中国现代医学杂志,2024,34(14):77-82,6.基金项目
广东省自然科学基金(No:2021A1515010215) （No:2021A1515010215）
