CAJ | 학술논문

目的：探讨脓毒症患者肾损伤程度与血浆血管生成素-1、2水平的相关性。方法96例入住 ICU 的脓毒症患者,按 AKIN 急性肾损伤标准分为脓毒症非 AKI 组(NAKI,n =46),AKIⅠ组(n =23),AKIⅡ组(n =11),AKIⅢ组(n =16),另选取30例健康体检者作为健康对照组(CON, n =30)。登记一般情况并进行急性生理和慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,采血检测血浆 Ang-1、 Ang-2、血肌酐(Scr),计算肌酐清除率(Ccr),统计分析其相关性。结果①与 CON 组比较,NAKI 、AKIⅠ、AKIⅡ、AKIⅢ组血浆 Ang-1水平明显降低(P <0.01),四组间差异无统计学意义(P >0.05)；血浆 Ang-2水平明显升高(P <0.01),且随 AKI 分级增高而明显升高(P <0.05)。②各组血浆 Ang-1水平与 Ccr 值无相关(P >0.05),各组血浆 Ang-2水平与 Ccr 值呈正相关(P <0.01),多元回归分析显示 Ang-2与 Ccr 值呈显著独立相关(P <0.01)。③血浆 Ang-1水平与 APACHEⅡ评分、SOFA 评分无相关(P >0.05),血浆 Ang-2水平与 APACHEⅡ评分、SOFA 评分呈正相关(P <0.01),多元回归分析显示 Ang-2与 APACHEⅡ评分、SOFA 评分均呈显著独立相关(P <0.05)。结论血浆 Ang-2水平是影响脓毒症患者肾损伤程度的独立危险因素。
목적：탐토농독증환자신손상정도여혈장혈관생성소-1、2수평적상관성。방법96례입주 ICU 적농독증환자,안 AKIN 급성신손상표준분위농독증비 AKI 조(NAKI,n =46),AKIⅠ조(n =23),AKIⅡ조(n =11),AKIⅢ조(n =16),령선취30례건강체검자작위건강대조조(CON, n =30)。등기일반정황병진행급성생리화만성건강상황(APACHEⅡ)평분、서관기관쇠갈(SOFA)평분,채혈검측혈장 Ang-1、 Ang-2、혈기항(Scr),계산기항청제솔(Ccr),통계분석기상관성。결과①여 CON 조비교,NAKI 、AKIⅠ、AKIⅡ、AKIⅢ조혈장 Ang-1수평명현강저(P <0.01),사조간차이무통계학의의(P >0.05)；혈장 Ang-2수평명현승고(P <0.01),차수 AKI 분급증고이명현승고(P <0.05)。②각조혈장 Ang-1수평여 Ccr 치무상관(P >0.05),각조혈장 Ang-2수평여 Ccr 치정정상관(P <0.01),다원회귀분석현시 Ang-2여 Ccr 치정현저독립상관(P <0.01)。③혈장 Ang-1수평여 APACHEⅡ평분、SOFA 평분무상관(P >0.05),혈장 Ang-2수평여 APACHEⅡ평분、SOFA 평분정정상관(P <0.01),다원회귀분석현시 Ang-2여 APACHEⅡ평분、SOFA 평분균정현저독립상관(P <0.05)。결론혈장 Ang-2수평시영향농독증환자신손상정도적독립위험인소。
Objective To investigate the relationship between the severity of kidney damage and the level of Ang-1 and Ang-2 in patients with sepsis. Methods 96 septic patients admitted to ICU were divided into NAKI group (n = 46),AKIⅠgroup (n = 23),AKIⅡ group (n = 11),AKIⅢ group (n = 16) according to different damage degrees under AKIN criteria, and 30 healthy people were also enrolled as healthy control group(n = 30). The clinical data including the acute physiology and chronic healthy conditions(APACHE) Ⅱ score and sequential organ failure(SOFA) score were collected and recorded. Blood samples were collected to detect plasma Ang-1,Ang-2 , Scr and Ccr and correlation was analyzed. Results ①The plasma Ang-1 levels in NAKI, AKIⅠ, AKIⅡ, AKIⅢ groups were significantly lower compared with CON group (P < 0. 01), but there were no differ-ence among the four groups (P > 0. 05). The plasma Ang-2 levels in NAKI, AKIⅠ,AKIⅡ,AKIⅢ groups were significantly higher compared with CON group (P < 0. 01), and the plasma Ang-2 levels of the four groups significantly increased as their AKI classification increased. ②The plasma Ang-1 level and Ccr was not correlated (P > 0. 05). The plasma Ang-2 level and Ccr was significant correlated (P < 0. 01). Multiple linear regression analysis showed that plasma Ang-2 level was significantly independ-ently correlated with Ccr (P < 0. 01). ③The plasma Ang-1 levels and the APACHEⅡ score and SOFA score were not correlated (P > 0. 05). The plasma Ang-2 levels and the APACHEⅡ score and SOFA score was positively correlated (P < 0. 01). Multiple linear regression analysis showed that plasma Ang-2 level was significantly independently correlated with the APACHEⅡ score and SOFA score (P < 0. 05). Conclusion The plasma Ang-2 level is an independent risk factor associated with severity of kidney damage of septic patients.