CAJ | 학술논문

目的研究白细胞介素-18 (IL-18)与冠脉搭桥手术后急性肾损伤(AKI)的关系.方法选择冠状动脉硬化性心脏病行冠脉搭桥手术的患者80例,根据AKI诊断标准,分为AKI组和非AKI组.分别留取术前及术后2、4、6、8、12、24 h等不同时间点的血液和尿液标本,测定标本中血清肌酐(Scr)、血液及尿液中IL-18水平.运用ROC曲线及曲线下面积评价尿液及血液的IL-18对AKI的敏感性及特异性.结果 80例患者共有13例发生AKI,发病率为16.25％,AKI组Scr升高峰值出现在24 ～ 48 h内.血、尿IL-18峰值均出现在术后4h,ROC曲线显示术后2h血及尿IL-18的AUC均＞0.8.Logistic回归分析表明术后2h血、尿IL-18是冠脉搭桥手术后AKI发生的有效预测指标.结论冠脉搭桥手术后血液及尿液IL-18可作为冠脉搭桥术后AKI早期诊断生物标志物.
목적 연구백세포개소-18 (IL-18)여관맥탑교수술후급성신손상(AKI)적관계.방법 선택관상동맥경화성심장병행관맥탑교수술적환자80례,근거AKI진단표준,분위AKI조화비AKI조.분별류취술전급술후2、4、6、8、12、24 h등불동시간점적혈액화뇨액표본,측정표본중혈청기항(Scr)、혈액급뇨액중IL-18수평.운용ROC곡선급곡선하면적평개뇨액급혈액적IL-18대AKI적민감성급특이성.결과 80례환자공유13례발생AKI,발병솔위16.25％,AKI조Scr승고봉치출현재24 ～ 48 h내.혈、뇨IL-18봉치균출현재술후4h,ROC곡선현시술후2h혈급뇨IL-18적AUC균＞0.8.Logistic회귀분석표명술후2h혈、뇨IL-18시관맥탑교수술후AKI발생적유효예측지표.결론 관맥탑교수술후혈액급뇨액IL-18가작위관맥탑교술후AKI조기진단생물표지물.
Objective To test the hypothesis that interleukin-18 (IL-18) in the urine and serum sample are early biomarker for acute kidney injury (AKI) in patients after coronary artery bypass graft surgery (CABG).Methods Eighty patients who underwent CABG were recruited.The patients were divided into AKI group and non-AKI group according to the AKI criteria.The urine and serum sample were collected at pre-operation and 2 h,4 h,6 h,8 h,12 h,24 h after the CABG.The urine and serum IL-18 value were test by ELISA method.Receiver-operating characteristic cue(ORC) and the area under the cure(AUC) asses the sensitivity and specificity of IL-18 for AKI.Results Thirteen of eighty cases(16.25％) developed postoperative AKI according to the AKI criteria.Diagnosis with creatinine was only 24-48 hours after CABG.The serum and urinary concentrations of IL-18 at mostly each time point after CABG in AKI patients were significantly higher than those in non-AKI patients(P ＜ 0.01).Urinary and serous concentrations of IL-18 peaked at 4 h after CABG in AKI patients.ROC curve showed AUC in urinary and serous concentrations of IL-18 at 2 h ＞ 0.8 ; Concentrations of IL-18 in urine and serum at 2 h were the powerful independent predictors of AKI by logistic regression analysis.Conclusion IL-18 in urine and serum after CABG surgery were the powerful independent predictors of AKI.