KIM-1和 CysC在重症急性胰腺炎合并急性肾损伤中的早期诊断价值

摘要

目的：探讨尿液中肾损伤分子-1（KIM-1）和胱抑素C（CysC）在急性重症胰腺炎（SAP）合并急性肾损伤（AKI）患者中的早期诊断价值。方法收集15例健康体检者作为正常对照，将161例急性胰腺炎（AP）患者分为轻度（MAP）、中度（MSAP）、重度（SAP）3组，其中SAP组又分为AKI和非AKI亚组。采用酶联免疫分析法（ELISA法）测定正常对照组及AP患者发病后12～24 h的尿液KIM-1、CysC水平。结果 SAP组中AKI 亚组的KIM-1和CysC水平明显高于非AKI 亚组（P＜0．01）。结论尿KIM-1和CysC可以作为检测SAP合并AKI的早期生物标记物。%Objective Severe acute pancreatitis (SAP) is usually complicated by the high incidence of acute kidney injury (AKI). Traditionally,AKI is diagnosed by measuring the increase of the serum creatinine concentration,but it is not a sensitive marker.This clinical study was designed to investigate whether human urinary KIM-1 and CysC can be regarded as early predictive markers for AKI following SAP.Methods Total of 161 cases of acute pancreatitis ( AP) patients were divided into the mild acute pancreatitis ( MAP) group,moderately severe acute pancreatitis ( MSAP) and SAP group,and the latter is divided into the non-AKI subgroup and the AKI subgroup.Meanwhile the control group was set up.Samples were collected from the control group and the patients with AP after 12 -24 h of the onset,and then KIM-1 and CysC levels were measured by using sandwich ELISA.Results The urinary KIM-1 and CysC levels in the AKI subgroup were significantly higher than those in the non-AKI subgroup (P<0.01).Conclusion Based on these results,we presume the urinary KIM-1 and CysC levels can be used as early potential markers of AKI following SAP.