慢性肾心综合征患者尿液肾损伤分子1水平变化及其与预后的关系

摘要

目的 探讨慢性肾心综合征(CRCS)患者尿液肾损伤分子1(KIM-1)水平变化及其与预后的关系.方法 选择CRCS患者27例,根据人院14 d内肾功能改变情况,分为肾功能改善组(A组)8例和肾功能未改善组(B组)19例.同期选择不合并心力衰竭的慢性肾衰竭患者13例作为慢性肾衰竭组(C组)、健康体检者10例作为对照组(N组).分别检测各组入院第1、7、14天时尿液KIM-1水平,并探讨其与肾小球滤过率估计值(eGFR)、血肌酐(SCr)的关系及其在判断CRCS预后中的价值.结果 入院第1天,A、B组尿液KIM-1水平较C、N组明显增加(P均＜0.05)；14 d后,A组尿液KIM-1水平较第1天明显下降(P＜0.05),其余各组无明显改变.相关分析显示,入院第1天CRCS患者尿液KIM-1与eGFR呈负相关(r=-0.245,P＜0.05),与SCr呈正相关(r=0.561,P＜0.05).ROC曲线分析显示,入院第1天时尿液KIM-1对CRCS患者预后判断能力较强.结论 早期检测尿液KIM-1水平有助于CRCS的早期诊断和预后判断.%Objective To investigate urinary kidney injury molecule 1 ( KIM-1) change and its significance in patients with chronic renocardiac syndrome (CRCS). Methods 27 CRCS patients were enrolled and divided into two groups, im-proved renal function group (group A) and unimproved renal function group (group B) , according to changes in renal func-tion within 14 days after admission.13 patients of chronic renal failure without heart failure as group C. Ten cases of healthy people as control group (group N). The urinary KIM-1 on day 1,7, 14 after admission in each group were tested, the re-lationships between eCFR and SCr, the value in determining prognosis were explored. Results One day after admission, the levels of urinary KIM-1 in group A and B markedly increased (P<0.05) and after 14 days, it significantly decreased in group A, while its levels in the remaining groups were not significantly decreased. One day after admission, urinary KIM-1 in group CRCS was negatively correlated with eGFR ( r = -0.245, P < 0.05 ) , and positively correlated with SCr (r =0.561, P<0.05). ROC curve analysis showed that one day after admission, urinary KIM-1 had a fairly good judg-ment on the prognosis of CRCS patients. Conclusions Testing the level of urinary KIM-1 early benefits for diagnosis and prognosis of CRCS patients.