尿肾损伤分子1与白细胞介素18对急性肾损伤患者的诊断价值

摘要

Objective To observe the urinary kidney injury molecule-1 (Kim-1)and interleukin-18 (IL-18)levels and evaluate whether they had diagnostic value in patients with acute kidney injury (AKI).Methods Seventy-one patients with AKI were selected as the study group (AKI group),and 30 healthy individuals were enrolled as the control group.The levels of Kim-1 and IL-18,and serum creatinine (SCr)level were determined.Results The urinary Kim-1 ,IL-1 8 and SCr levels were in-creased significantly (P<0.01 or P<0.05)in AKI group as compared with control group.The urina-ry Kim-1 and SCr levels were increased significantly (P<0.01)in AKI stage 1,2 and 3 groups,and the urinary IL-18 increased significantly (P<0.01)in AKI stage 2 and 3 groups as compared with control group.However,there was no statistically significant difference in the urinary IL-1 8 between AKI stage 1 group and control group.The urinary Kim-1 and SCr levels were increased significantly (P<0.01)in AKI stage 2 and 3 groups,and the urinary IL-18 increased significantly in AKI stage 2 group (P<0.05)and AKI stage 3 group (P<0.01)as compared with AKI stage 1 group.The urina-ry Kim-1,IL-18 and SCr levels were increased significantly (P<0.01)in AKI stage 3 group as com-pared with AKI stage 2 group.Correlation analysis revealed that the urinary Kim-1 was positively cor-related with SCr and urinary IL-18 (r=0.842,P<0.01),the urinary IL-18 was positively correlated with SCr (r=0.785,P<0.01),and the urinary Kim-1 was positively correlated with the urinary IL-18 (r=0.756,P<0.01).The area under the receiver operating characteristics curve analysis revealed that the urinary Kim-1 (0.915)was greater than the urinary IL-18 (0.807)(P<0.05).Conclusions The urinary Kim-1 and IL-1 8 were increased significantly in AKI group.Both of them may be used as diagnostic criteria for AKI,and the diagnostic value of the urinary Kim-1 may be greater.%目的：观察尿肾损伤分子1(kidney inj ury molecule-1,Kim-1)与白细胞介素18(inter-leukin-18,IL-18)在急性肾损伤(acute kidney injury,AKI)患者中的变化,探讨其对 AKI的诊断价值。方法选择我院确诊为AKI患者71例(AKI组),并根据AKI分期,分为AKI 1期组23例、AKI 2期组25例和 AKI 3期组23例；另选择同时期我院体检中心健康体检者30名(健康对照组),分别检测2组患者尿Kim-1、尿 IL-18及血肌酐(SCr)水平。结果 AKI组 SCr、尿Kim-1较健康对照组明显升高(P<0.01),尿 IL-18亦升高(P<0.05),与健康对照组比较,SCr、尿 Kim-1在 AKI 1期组、AKI 2期组、AKI 3期组均明显升高(P<0.01),尿 IL-18在 AKI 2期组、AKI 3期组亦明显升高(P<0.01),在 AKI 1期组虽升高,但差异无统计学意义(P>0.05)；与 AKI 1期组比较,SCr、尿 Kim-1在 AKI 2期组、AKI 3期组均明显升高(P<0.01),尿IL-18在AKI 2期升高(P<0.05),在AKI 3期组亦升高(P<0.01),与 AKI 2期组比较,SCr、尿 Kim-1及尿 IL-18在 AKI 3期组均明显升高(P<0.01)；而且相关性分析显示,尿 Kim-1与 SCr 呈正相关(r=0.842,P<0.01)；尿 IL-18与 SCr 呈正相关(r=0.785,P<0.01)；尿Kim-1与尿 IL-18呈正相关(r=0.756,P<0.01)。而 ROC 曲线下面积比较结果显示,尿Kim-1(0.915)明显大于尿 IL-18(0.807)(P<0.05)。结论尿 Kim-1、尿 IL-18在 AKI患者中升高,二者均可能作为 AKI的诊断标准,且尿Kim-1诊断价值可能更高。