脓毒症患者血清LRG、suPAR水平对并发急性肾损伤的 预测价值

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中图分类号：R631.2文献标志码：AD0I：10.11958/20252777

Abstract：ObjectiveTo investigate changes serum levels leucine-rich α -2 glycoprotein （LRG） and soluble urokinase-type plasminogen activator receptor （suPAR）in sepsis patients and their predictivevalue for concurrent acute kidneyinjury（AKI）.MethodsAtotal2Osepsis patients were includedand dividedinto theAKIgroupandthe nonAKI groupaccording to whether AKIoccurred withinone week after admission.Another2O cases healthy individuals who underwent physical examinations in thesame period were includedas the health group.The serum levelsLRGl and suPAR were detected by enzyme-linked immunosorbent assay （ELISA）. Receiver operating characteristic （ROC） curve was used to evaluate the predictive eficacy serum LRG and suPAR for sepsis-associated AKI. Decision curve analysis （DCA） was used toanalyze the clinical utility serum LRGandsuPAR inpredictingsepsiscomplicatedwithAKI.Logistic regression was used to analyzethe influencing factors sepsiscomplicated withAKI.ResultsTheserumexpressionlevels LRGland suPAR in patients were significantly higherin thedisease groupthan those in the healthycontrol group（ P< 0.05）.The proportionvasoactivedrugapplication，sequentialorganfailureassssmentscore，acutephysiologyandhronic health evaluation I score，procalcitonin，blood lactate （Lac），LRG and suPAR levels were higher in the AKI group than those in the non-AKI group P<0.05 ）. The area under the curve （AUC） combined prediction sepsis complicated with AKI was 0.850（95%Cl： 0.773-0.909）， which was beter than that LRG or suPAR alone （Z=2.85，2.464，both P<0.05 ） Whenthehighrisk thresholdwasO.O-.0，thenetbenefitratecombineddetectionthetwotestsinpredictingsepsis complicated withAKIwaseter thanthatsngledetection.IncreasedLRGlevelincreasedsuPARlevel，increasedLac leveland the use vasoactive drugs were independent risk factors for sepsis complicated with AKI.ConclusionSerum LRG andsuPARlevelsare increased insepsis patientsandarerelated factors affectingAKI.Thecombination the two has a higher predictive value.

Keywords：sepsis;acute kidney injury；receptors，urokinase plasminogenactivator;ROC curve;leucine-rich α -2 glycoprotein

脓毒症是机体对感染的反应失调，进而导致危及生命的器官功能障碍的一种疾病，其中急性肾损伤（acutekidneyinjury，AKI）作为其常见并发症，威胁生命安全[。（剩余9336字）