论文部分内容阅读
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。
OBJECTIVE: To investigate the relationship between serum and urinary interleukin 18 (IL-18) and kidney injury molecule 1 (KIM-1) in patients with acute kidney injury after coronary intervention injury, AKI) value in early diagnosis. Methods: A total of 243 patients diagnosed as CHD by PCI were enrolled in Department of Cardiology, Second People’s Hospital of Pingdingshan City, Henan Province. They were divided into AKI group (48 cases) and non-AKI group (195 cases) 4, 6, 8, 10, 12, 24, 48 and 72 h blood and urine samples were collected. Serum creatinine (SCr), IL-18 and KIM- IL-18 and KIM-1 levels. Results: The SCr values at 12, 24, 48 and 72 h after AKI were significantly higher than those at 0 h baseline (all P <0.05). The levels of IL-18 and KIM-1 (P <0.05), peaked at 2 h (blood) or 4 h (urine), KIM-1 peaked at 6 h (blood) or 8 h ). Pearson correlation analysis showed that the levels of KIM-1 in blood (2 h), urinary (4 h) IL-18 and blood (6 h) and urine (8 h) in AKI group were positively correlated with SCr (P <0.05). The ROC curve analysis showed that the area under the ROC curve (AUC) of KIM-1 of blood (2 h), urine (4 h) IL-18 and blood (6 h) (2 h), urinary (4 h) IL-8 and blood (6 h), urinary (8 h) KIM-1 combined detection of AKI were greater than the two AUC Test alone. Conclusions: The combined detection of KIM-1 and urine KIM-1 at 6 h, blood IL-18 at 4 h, IL-18 at 4 h, KIM-1 and urine at 1 h after coronary intervention in patients with coronary heart disease has a good diagnosis of AKI Efficacy, there is a certain diagnostic value, which may be an important reference for early diagnosis of AKI.