武警医学2025，Vol.36Issue(5)：388-393,398,7.
探讨三种检测指标对婴幼儿心脏手术后急性肾损伤的早期价值
Predictive value of three detection indicators for acute kidney injury after cardiac sur-gery in infants and young children
摘要
Abstract
Objective To explore the early diagnostic value of Dickkopf-associated protein 3(DKK3)tissue preparation of metalloproteinase 2(TIMP-2),and human insulin-like growth factor binding protein 7(IGFBP7)for acute kidney injury(AKI)in in-fants and young children after cardiopulmonary bypass(CPB)cardiac surgery.Methods A total of 50 children who underwent car-diac surgery at the Seventh Medical Center of PLA General Hospital from December 2020 to April 2022 were selected,and divided into the AKI group and the non-AKI group according to the criteria of the International Group for Improving Global Prognosis of Ne-phrology(KDIGO).The concentrations of DKK3 and[TIMP-2]•[IGFBP7]in the urine of the two groups before the operation,3 hours after CPB,and 24 hours after CPB were compared.The diagnostic value of postoperative AKI was evaluated by using the re-ceiver operating characteristic curve(ROC).Results Compared with the non-AKI group,the preoperative DKK3 levels and the lev-els of TIMP-2]•[IGFBP7]at 3 and 24h after CPB were significantly increased in the AKI group.Logistic regression analysis showed that the preoperative DKK3(OR=26.32,95%CI:1.75～396.30,P=0.018),and[TIMP-2]•[IGFBP7]at 3h after CPB(OR=1.22,95%CI:1.03～1.43,P=0.022)and 24h after CPB(OR=1.16,95%CI:1.02～1.31,P=0.021)were independent risk factors for AKI after cardiac surgery.The ROC analysis further confirmed that the preoperative DKK3(AUC=0.75),[TIMP-2]•[IGFBP7]at 3h af-ter CPB AUC=0.77)and 24h after CPB(AUC=0.75)had relatively high predictive value.Specific threshold analysis indicated that when preoperative DKK3 was less than 1.89 ng/ml and[TIMP-2]•[IGFBP7]was<0.32(ng/ml)2/1000 at 3 h and 24 h after CPB,the risk of AKI was significantly reduced.Conclusions Urinary DKK3 and TIMP-2]•[IGFBP7]serve as valuable biomarkers for the early detection of AKI after cardiac surgery in Chinese infants and young children.关键词
Dickkopf相关蛋白3/金属蛋白酶组织制剂2/人胰岛素样生长因子结合蛋白7/急性肾损伤/体外循环/婴幼儿Key words
DKK3/TIMP-2/IGFBP7/acute kidney injury/cardiopulmonary bypass/infants and young children分类
医药卫生引用本文复制引用
范春玲,郭文治,刘永哲..探讨三种检测指标对婴幼儿心脏手术后急性肾损伤的早期价值[J].武警医学,2025,36(5):388-393,398,7.基金项目
首都卫生发展科研专项项目(2020-2-5092) （2020-2-5092）
