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

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,根据入院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。

Change of urinary kidney injury molecule 1 in patients with chronic renocardiac syndrome and its significance

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,improved renal function group(group A)and unimproved renal function group(group B),according to changes in renal function 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 relationships between eGFR 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 judgment on the prognosis of CRCS patients.Conclusions Testing the level of urinary KIM-1 early benefits for diagnosis and prognosis of CRCS patients.